Individual provider Active NPI

Anne Kristin Doran, MD

  • Pediatrics Physician
  • Park Ridge, IL
National Provider Identifier
1982930509
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036139282 Issued in IL
Practice address
1675 W Dempster St FL 1
Park Ridge, IL 60068-1110
Phone
(847) 318-9300
Fax
(847) 723-9583
NPI assigned
Nov 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R70723 AZ
Pediatrics Physician 208000000X 036139282 IL Primary

Addresses

Primary practice location

1675 W Dempster St FL 1
Park Ridge, IL 60068-1110

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other identifiers 1

IdentifierTypeStateIssuer
036139282MedicaidIL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address adoran237676@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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
I20160325000001 IL Practitioner - Pediatric Medicine 7416080668 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R70723AZMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Jun 26, 2022 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Mar 14, 2016 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Mar 14, 2016 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

1675 W Dempster St
Fl 1
Park Ridge, IL 60068
Phone (847) 318-9300

Interoperability endpoints

  • Direct secure messaging: adoran237676@direct.myadvocateaurora.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1982930509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 W DEMPSTER ST FL 1",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681110",
            "telephone_number": "847-318-9300",
            "fax_number": "847-723-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORAN",
        "first_name": "ANNE",
        "middle_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "R70723",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036139282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036139282",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adoran237676@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1675 W Dempster St Fl 1",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1675 W Dempster St Fl 1",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.