Trevor Michael Bullock, DO

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

036141777 Issued in IL

Practice address

920 Milwaukee Ave
Lincolnshire, IL 60069

Phone

(847) 866-7846

Fax

(224) 251-4568

NPI assigned

Jul 7, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Sports MedicineAlso: Family Practice

Education

Ohio University, College of Osteopathic Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
• Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252
• Swedish Hospital Hospital, Chicago, IL, CCN 140114
• Shirley Ryan Abilitylab Inpatient rehabilitation facility, Chicago, IL, CCN 143026

Merit-based Incentive Payment System (MIPS)

Final score

84.9 of 100Reported as group

Quality

75.91

Promoting interoperability

99

Improvement activities

40

Cost

74.6

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbullock262295@direct.northshore.org

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.

• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Endeavor Health Clinical Operations

  • Psychiatric Hospital Unit
  • Highland Park, IL
  • NPI 1770527236
  NPD (past)

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

• Endeavor Health Clinical Operations

  • General Acute Care Hospital
  • Evanston, IL
  • NPI 1184670549
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1578932869
  Care Compare affiliation
• Northwest Community Hospital

  • General Acute Care Hospital
  • Arlington Heights, IL
  • NPI 1770531600
  Care Compare affiliation
• Rehabilitation Institute of Chicago

  • Rehabilitation Hospital
  • Chicago, IL
  • NPI 1205879095

  Inpatient rehabilitation facility

  Care Compare affiliation
• Swedish Covenant Health

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1831151257
  Care Compare affiliation

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

{
    "created_epoch": "1215388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1881857282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 MILWAUKEE AVE",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693839",
            "telephone_number": "847-866-7846",
            "fax_number": "224-251-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 MILWAUKEE AVE",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "60069",
            "telephone_number": "847-866-7846",
            "fax_number": "224-251-4568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2180 Pfingsten Rd",
            "address_2": "Suite 3100",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261339",
            "country_code": "US",
            "telephone_number": "847-866-7846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "TREVOR",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-07",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036141777",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036141777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbullock262295@direct.northshore.org",
            "affiliation": "N",
            "address_1": "920 Milwaukee Ave",
            "city": "Lincolnshire",
            "state": "IL",
            "country_code": "US",
            "postal_code": "60069",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bethany Bowkett
• Carolyn Brady, PT
• Dolores Imroth Braun, LCPC
• Kristen Britton
• Barbara Bugner, RN
• Christine M. Burback, LCPC NCC
• Richard A. Caner, M.D.
• Katherine J Carmody
• Claudia Carone, LPC
• Gregory George Caronis, MD

• Sports Medicine (Family Medicine) Physician in Lincolnshire, IL
• Providers in Lincolnshire, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; 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.

Verify at the official NPI Registry.