NPIMap

Individual provider Active NPI

Evan Augustine Dougherty, M.D.

  • Orthopaedic Trauma Physician
  • Hinsdale, IL
National Provider Identifier
1871828947
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
036137517 Issued in IL
Practice address
550 W Ogden Ave
Hinsdale, IL 60521-3186
Phone
(630) 323-6116
NPI assigned
Oct 7, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 125-056811 IL
Orthopaedic Trauma Physician 207XX0801X 036137517 IL Primary

Addresses

Primary practice location

550 W Ogden Ave
Hinsdale, IL 60521-3186

Mailing address

550 W Ogden Ave
Hinsdale, IL 60521-3186
Phone (630) 323-6116

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
I20150826001475 IL Practitioner - Orthopedic Surgery 2769608132 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
West Virginia University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1870 Silver Cross Blvd
New Lenox, IL 60451-8639
Phone (815) 462-3474

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.07 of 100Reported as group
Quality
76.54
Promoting interoperability
83
Improvement activities
40
Cost
74.52

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125-056811ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hinsdale Orthopaedic Associates, SC Orthopaedic Surgery CurrentSince Jun 8, 2018 Accepting new patients
Illinois Bone and Joint Institute LLC Orthopaedic Surgery CurrentSince Oct 1, 2020 Accepting new patients
Illinois Bone and Joint Institute, LLC Orthopaedic Surgery CurrentSince Oct 1, 2020 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

550 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 323-6116

1870 Silver Cross Blvd
Ste 200
New Lenox, IL 60451
Phone (630) 323-6116

4700 Gilbert Ave
Ste 51
Western Springs, IL 60558
Phone (708) 387-1737

1010 Executive Dr
Ste 250
Westmont, IL 60559
Phone (630) 655-8785

Organizations & group practices 5

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.

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": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1871828947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213186",
            "telephone_number": "630-323-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 W OGDEN AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605213186",
            "telephone_number": "630-323-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "EVAN",
        "middle_name": "AUGUSTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-07",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "125-056811",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "IL",
            "license": "036137517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinsdale, IL

Sources for this page

Verify at the official NPI Registry.