Active NPI
Michael H Hamblin, M.D.
- Diagnostic Radiology Physician
- Evanston, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036111302
- Practice address
- 355 Ridge Ave
Evanston, IL 60202-3328 - Phone
- (847) 316-6101
- NPI assigned
- Jun 6, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 036111302 | IL | Primary |
Addresses
Primary practice location
355 Ridge Ave
Evanston, IL 60202-3328
Mailing address
355 Ridge Ave
Evanston, IL 60202-3328
Phone (847) 316-6101
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01615776 | Other | IL | BCBS PROVIDER NUMBER |
| 036111302 | Medicaid | IL | |
| P00280131 | Other | IL | RR MEDICARE |
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
- Diagnostic Radiology
- Education
- University of Michigan Medical School, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1041 W Stearns Rd
Bartlett, IL 60103-4509
Phone (630) 716-7500
1555 Barrington Rd
Hoffman Estates, IL 60169-1019
Phone (847) 490-6945
1786 Moon Lake Blvd
Hoffman Est, IL 60194-5029
Phone (847) 755-8208
361 W Golf Rd
Schaumburg, IL 60195-3607
Phone (847) 952-7447
800 Biesterfield Rd
Elk Grove Village, IL 60007-3361
Hospital & facility affiliations
- St Alexius Medical Center
- Alexian Brothers Medical Center 1
- Northwestern Medicine Central Dupage Hospital
- Northwestern Medicine McHenry
- Northwest Community Hospital 1
Merit-based Incentive Payment System (MIPS)
- Final score
- 49.59 of 100
- Quality
- 62.57
- Improvement activities
- 0
- Cost
- 70.1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036111302 | IL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bonaventure Medical Foundation, LLC | Current | Accepting new patients | |
| Midwest Imaging Professionals, LLC | Diagnostic Radiology | Past | Accepting new patients |
Locations
7435 W Talcott Ave
Chicago, IL 60631
Phone (773) 467-9977
355 Ridge Ave
Evanston, IL 60202
Phone (847) 316-2329
1555 N Barrington Rd
Hoffman Estates, IL 60169
Phone (847) 490-2923
1786 Moon Lake Blvd
Hoffman Estates, IL 60169
Phone (847) 640-5640
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.
-
- Family Medicine Physician
- Elk Grove Village, IL
- NPI 1588775647
-
- Diagnostic Radiology Physician
- Hoffman Estates, IL
- NPI 1962507889
-
- Diagnostic Radiology Physician
- Chicago, IL
- NPI 1609139419
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elk Grove Village, IL
- NPI 1265577191
-
- General Acute Care Hospital
- Winfield, IL
- NPI 1003864810
-
- Psychiatric Hospital Unit
- Winfield, IL
- NPI 1740230895
-
- General Acute Care Hospital
- McHenry, IL
- NPI 1982611281
-
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1578932869
-
- General Acute Care Hospital
- Arlington Heights, IL
- NPI 1770531600
-
- General Acute Care Hospital
- Hoffman Estates, IL
- NPI 1376644385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380067200000",
"number": "1891734596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 RIDGE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602023328",
"telephone_number": "847-316-6101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 RIDGE AVE",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602023328",
"telephone_number": "847-316-6101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMBLIN",
"first_name": "MICHAEL",
"middle_name": "H",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-06",
"last_updated": "2013-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036111302",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "01615776",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036111302",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00280131",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.