DR. MARY TILLEY JENKINS VOGEL (NPI# 1023247236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023247236 |
| Entity Type | Individual |
| Full Name | DR. MARY TILLEY JENKINS VOGEL |
| Credential | MD |
| Practice Address |
2650 Ridge Ave. Kellogg Cancer Center Evanston IL 60201 |
| Mailing Address |
2650 Ridge Ave. Kellogg Cancer Center Evanston IL 60201-1718 |
| Practice Telephone | 8475702639 |
| Practice Fax Number | 8475701041 |
| Mailing Telephone | 8475702639 |
| Mailing Fax Number | 8475701041 |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2018-11-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 036140981 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
2650 RIDGE AVE. KELLOGG CANCER CENTER |
| City | EVANSTON |
| State | IL |
| Zip Code | 60201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407841414 | Sidney P. Regalado | Radiology | 2650 Ridge Ave., Department of Radiology, Evanston, IL 60201-1718 | 2005-09-15 |
| 1417554130 | Stephanie Rene Gerberding | Social Worker | 2650 Ridge Ave., Dept. of Psychiatry, Evanston, IL 60202-1011 | 2020-10-06 |
| 1376196006 | Brenna Selena Leiker | Physician Assistant | 2650 Ridge Ave., Emergency Medicine, Evanston, IL 60201-1718 | 2019-07-22 |
| 1225598022 | Lindsey Weder Zimmerman | Nurse Anesthetist, Certified Registered | 2650 Ridge Ave., Department of Anesthesia, Evanston, IL 60201-1718 | 2019-03-20 |
| 1265996631 | Madeline S. Lubenow | Nurse Anesthetist, Certified Registered | 2650 Ridge Ave., Department of Anesthesia, Evanston, IL 60201-1718 | 2019-01-30 |
| 1295203768 | Gayathri S. Moorthy | Registered Nurse | 2650 Ridge Ave., Kellogg Cancer Center, Evanston, IL 60201-1718 | 2018-11-02 |
| 1700385077 | Glenna M Daugherty | Nurse Practitioner | 2650 Ridge Ave., Emergency Medicine, Evanston, IL 60201-1718 | 2018-02-01 |
| 1164942066 | Danijela Dokic | Internal Medicine | 2650 Ridge Ave., Im Hospitalists Ste 4210, Evanston, IL 60201 | 2017-06-21 |
| 1417487612 | Julie Elaine Rzeszutko | Internal Medicine | 2650 Ridge Ave., Im Hospitalists Ste 4210, Evanston, IL 60201 | 2017-06-20 |
| 1144757154 | Bukurije Alijoski | Nurse Practitioner | 2650 Ridge Ave., Palliative Care, Evanston, IL 60201-1718 | 2017-05-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356962898 | Sebastian Andres Cruz | Internal Medicine | Northshore University Healthsystem, Off of Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2020-05-06 |
| 1053970442 | Wade Gilman | Family Medicine | 1650 Ridge Ave, Ste 1304, Evanston, IL 60201 | 2019-06-10 |
| 1922577949 | Elizabeth Wilton Therapy, LLC | Counselor | 2901a Central St Ste 3, Evanston, IL 60201 | 2018-11-20 |
| 1952887812 | Sg Wellness LLC | Clinic/Center | 3008 Central Street, Evanston, IL 60201 | 2018-07-13 |
| 1689169591 | Michael Kert Zijlstra | Internal Medicine | Northshore University Healthsystem Office of Academic, Affairs 2650 Ridge Ave, Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1982199725 | Elizabeth Hannah Lees | Internal Medicine | Northshore University Healthsystem Office of Academic A, 2650 Ridge Ave Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1730674565 | Ashley Elizabeth Aller | Internal Medicine | Northshore University Healthsystem, Office Acad Affairs, 2650 Ridge Ave., Suite 1304, Evanston, IL 60201 | 2018-06-25 |
| 1669967683 | Ayush N Shah | Internal Medicine | 2650 Ridge Ave Ste 5315, Evanston, IL 60201 | 2018-06-22 |
| 1811481062 | Jeffrey D. Brow | Internal Medicine | 2650 Ridge Ave Rm 5315, Evanston, IL 60201 | 2018-06-20 |
| 1831687250 | Michael Patrick Murphy | Radiology | 807 Davis St. Unit 707, Evanston, IL 60201 | 2018-05-01 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093162133 | Joel D Winer | Obstetrics & Gynecology | Office of Academic Affairs, 2650 Ridge Ave Ste 1304, Evanston, IL 60201 | 2016-05-18 |
| 1598108615 | Melissa Hachen Lippitt | Obstetrics & Gynecology | 2650 Ridge Ave # G800, Evanston, IL 60201-1700 | 2013-04-08 |
| 1689971665 | Midwest Center for Women's Healthcare | Obstetrics & Gynecology | 1000 Central St Ste 752, Evanston, IL 60201-1779 | 2011-02-28 |
| 1194992339 | Miriah D Plawer-volmerding | Obstetrics & Gynecology | 1000 Central St Ste 700, Evanston, IL 60201-1769 | 2008-05-15 |
| 1740341502 | Christopher Wallace Talbot | Obstetrics & Gynecology | 2639 Broadway Ave, Evanston, IL 60201-1555 | 2006-12-13 |
| 1730249707 | James Osborn Lowry | Obstetrics & Gynecology | 2807 Central St, Evanston, IL 60201-1221 | 2006-12-11 |
| 1366500449 | Eric C Hansen | Obstetrics & Gynecology | 150 Arrowhead Drive, Ste 2, Evanston, WY 82930 | 2006-12-04 |
| 1376658591 | Riley P. Lloyd, Md, Sc | Obstetrics & Gynecology | 800 Austin St Ste 354, St Francis Professional Bldg, Evanston, IL 60202-3454 | 2006-08-20 |
| 1285626630 | Carol M Cislak | Obstetrics & Gynecology | 2500 Ridge Ave Ste 311, Evanston, IL 60201-2477 | 2005-08-19 |
| 1316939994 | Chimene A Pellar | Obstetrics & Gynecology | 1000 Central St Ste 717, Evanston, IL 60201-1779 | 2005-08-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.