Active NPI
Evelyn Hani Hofferica, M.D.
- Anesthesiology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 036-129403
- Practice address
- 2875 W 19TH St
Chicago, IL 60623-3501 - Phone
- (708) 692-9525
- NPI assigned
- Mar 30, 2009
- 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 |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 036-129403 | IL | Primary |
Addresses
Primary practice location
2875 W 19TH St
Chicago, IL 60623-3501
Mailing address
PO Box 631
Lake Forest, IL 60045-0631
Other practice location 1
300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 208-4060
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01421150 | Other | IL | MEDICARE RAILROAD |
| F400146778 | Other | IL | MEDICARE |
| 036129403 | Medicaid | IL |
Other names 1
- Dr. Evelyn Hani Fakhoury
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 Randall Rd
Geneva, IL 60134-4200
Phone (630) 208-4060
304 Randall Rd
Geneva, IL 60134-4200
Phone (630) 352-5450
660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146
675 N Saint Clair St
Chicago, IL 60611-5975
675 N St Clair
Chicago, IL 60611-5975
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.19 of 100
- Quality
- 83.05
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-129403 | IL | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients |
Locations
Dept 5777
Carol Stream, IL 60122
300 Randall Rd
Geneva, IL 60134
Phone (630) 208-4009
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
Organizations & group practices 3
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.
-
dba Northwestern Medical Group
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
- Anesthesiology Physician
- Chicago, IL
- NPI 1174035513
-
dba Northwestern Medical Group
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Northwestern Medicine Central Dupage Hospital
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
dba Northwestern Medicine Central Dupage Hospital
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
dba Northwestern Medicine Delnor Community Hospital
- General Acute Care Hospital
- Geneva, IL
- NPI 1407859655
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707350400000",
"number": "1780826370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 631",
"city": "LAKE FOREST",
"state": "IL",
"postal_code": "600450631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2875 W 19TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606233501",
"telephone_number": "708-692-9525"
}
],
"practiceLocations": [
{
"address_1": "300 Randall Rd",
"address_purpose": "LOCATION",
"city": "Geneva",
"state": "IL",
"postal_code": "601344200",
"country_code": "US",
"telephone_number": "630-208-4060",
"fax_number": "630-208-4401",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOFFERICA",
"first_name": "EVELYN",
"middle_name": "HANI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-30",
"last_updated": "2024-02-08",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "IL",
"license": "036-129403",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P01421150",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "F400146778",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036129403",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "EVELYN",
"last_name": "FAKHOURY",
"middle_name": "HANI",
"prefix": "DR.",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Chicago, IL
- James Michael Hofert, MAPCC
- Frederick Hoff, MD
- Kaitlyn Elizabeth Hoff, DC
- Kristi E Hoff, M.S., CCC-SLP
- Nicole Hoff, PT
- Hoffman & Unterbrunner of Mayfair
- Hoffman and Unterbrunner, LLC (The Chicago Dental Studio)
- Hoffman of Bucktown PLLC
- Hoffman of Lakeview P.C. (The Chicago Dental Studios)
- Hoffman of LP PLLC (The Chicago Dental Studio)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.