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Individual provider Active NPI

Ewa V Hampston, M.D.

  • Family Medicine Physician
  • Palos Heights, IL
National Provider Identifier
1770694200
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036-111262 Issued in IL
Practice address
12130 S Harlem Ave
Suite B
Palos Heights, IL 60463-1458
Phone
(708) 448-5500
Fax
(708) 448-5501
NPI assigned
Aug 31, 2006
Last updated
Sep 23, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036-111262 IL Primary

Addresses

Primary practice location

12130 S Harlem Ave
Suite B
Palos Heights, IL 60463-1458

Mailing address

12130 S Harlem Ave
Suite B
Palos Heights, IL 60463-1458
Phone (708) 448-5500

Other identifiers 1

IdentifierTypeStateIssuer
P00215605OtherILRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041020000691 IL Practitioner - Family PracticePractitioner - General PracticePractitioner - Geriatric Medicine 3274594569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12130 S Harlem Ave
Suite B
Palos Heights, IL 60463-1459
Phone 70844855002

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-111262ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ewa V. Hampston MD SC Family Medicine CurrentSince Sep 3, 2009 Accepting new patients
Beata I Styka MD SC CurrentSince Sep 15, 2009 Accepting new patients

Locations

12130 S Harlem Ave
Ste B
Palos Heights, IL 60463
Phone (708) 229-1995

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1770694200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12130 S HARLEM AVE",
            "address_2": "SUITE B",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631458",
            "telephone_number": "708-448-5500",
            "fax_number": "708-448-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12130 S HARLEM AVE",
            "address_2": "SUITE B",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631458",
            "telephone_number": "708-448-5500",
            "fax_number": "708-448-5501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMPSTON",
        "first_name": "EWA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-111262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00215605",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.