Active NPI
Marilyn L Evrard, MD
- Medical Oncology Physician
- Elmhurst, IL
National Provider Identifier
1760471031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- 036023688
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036023688 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036023688 | IL | MD | Medical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New 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
- 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.
-
- Hematology & Oncology Physician
- Chicago, IL
- NPI 1538120381
-
- Hematology & Oncology Physician
- Niles, IL
- NPI 1164483913
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.