Individual provider Active NPI

Michael H Hamblin, M.D.

  • Diagnostic Radiology Physician
  • Evanston, IL
National Provider Identifier
1891734596
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036111302 Issued in IL
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

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
01615776OtherILBCBS PROVIDER NUMBER
036111302MedicaidIL
P00280131OtherILRR 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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050830000912 IL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 5890726756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
University of Michigan Medical School, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bonaventure Medical Foundation LLCGroup PAC ID 7517863178, 164 clinicians

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 Hospital, Hoffman Estates, IL, CCN 140290
  • Alexian Brothers Medical Center 1 Hospital, Elk Grove Village, IL, CCN 140258
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242
  • Northwestern Medicine McHenry Hospital, McHenry, IL, CCN 140116
  • Northwest Community Hospital 1 Hospital, Arlington Heights, IL, CCN 140252

Merit-based Incentive Payment System (MIPS)

Final score
49.59 of 100Reported as individual
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

LicenseStateTypeSpecialty
036111302ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bonaventure Medical Foundation, LLC CurrentSince Jul 9, 2025 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.

Hospital & facility affiliations 7

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": "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

Verify at the official NPI Registry.