Individual provider Active NPI

Marilyn L Evrard, MD

  • Medical Oncology Physician
  • Elmhurst, IL
National Provider Identifier
1760471031
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
036023688 Issued in IL
Practice address
1200 S York Rd
Ste 3280
Elmhurst, IL 60126-5626
Phone
(630) 758-8640
Fax
(630) 758-8642
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Oncology Physician 207RX0202X 036023688 IL Primary

Addresses

Primary practice location

1200 S York Rd
Ste 3280
Elmhurst, IL 60126-5626

Mailing address

1200 S York St
Ste. 3280
Elmhurst, IL 60126-5626
Phone (630) 758-8640

Other identifiers 1

IdentifierTypeStateIssuer
036023688MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036023688ILMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hematology Oncology Associates of Illinois LLC Current Accepting new patients
Illinois Cancer Specialists Past Accepting new patients

Locations

25068 Network Pl
Chicago, IL 60673

715 W North Ave
Melrose Park, IL 60160
Phone (708) 450-4554

6909 North Ave
Oak Park, IL 60302
Phone (708) 386-1112

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

Interoperability endpoints

  • Direct secure messaging: mevrard117296@direct.edward.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1760471031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S YORK ST",
            "address_2": "STE. 3280",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "630-758-8640",
            "fax_number": "630-758-8642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S YORK RD",
            "address_2": "STE 3280",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265626",
            "telephone_number": "630-758-8640",
            "fax_number": "630-758-8642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVRARD",
        "first_name": "MARILYN",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "IL",
            "license": "036023688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036023688",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.