DR. MICHAEL PRENDERGAST (NPI# 1568570158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568570158 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL PRENDERGAST |
| Credential | MD |
| Practice Address |
800 Austin St East Tower, Suite 563 Evanston IL 60202-3439 |
| Practice Telephone | 8478690522 |
| Practice Fax Number | 8478690652 |
| Mailing Telephone | 8478690522 |
| Mailing Fax Number | 8478690652 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2008-02-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS BLUE SHIELD | 01600655 | 01 |
| IL | 036091607 | 05 | |
| IL | RAILROAD MEDICARE | 020029783 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619365053 | Michael Joseph Prendergast | Urology | 1165 Turnberry Ln, York, PA 17403-9116 | 2015-01-08 |
| 1730743964 | Michael Patrick Prendergast | Student in an Organized Health Care Education/Training Program | 1 Childrens Plz, Dayton, OH 45404-1873 | 2019-04-23 |
| 1518278886 | Michael John Prendergast | Psychologist | 3591 Reserve Commons Dr, Suite 301, Medina, OH 44256-5334 | 2010-07-01 |
| 1245568088 | Michael Prendergast | Pediatrics | Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 | 2009-12-04 |
| 1780851113 | Michael A Prendergast | Emergency Medicine | 777 Bannock St, Mc 7782, Denver, CO 80204-4507 | 2008-05-14 |
| 1003886920 | Michael J Prendergast | Nurse Practitioner | 22089 Us Highway 19 N, Clearwater, FL 33765-2364 | 2006-01-24 |
| Street Address |
800 AUSTIN ST EAST TOWER, SUITE 563 |
| City | EVANSTON |
| State | IL |
| Zip Code | 60202-3439 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506665 | Thomas J Campbell | Internal Medicine | 800 Austin St, Ste 451e, Evanston, IL 60202-3455 | 2005-05-27 |
| 1518579739 | Rizwana Patel | Nurse Practitioner | 800 Austin St, Evanston, IL 60202-3439 | 2020-08-19 |
| 1467949594 | Hazel H Almores | Nurse Practitioner | 800 Austin St, East Tower, Ste 360, Evanston, IL 60202 | 2018-04-14 |
| 1073043469 | Envision Mobile Imaging, LLC | Clinic/Center | 800 Austin St, Evanston, IL 60202-3439 | 2017-06-18 |
| 1407209265 | Czamira Alba | Nurse Practitioner | 800 Austin St, Ste 369, Evanston, IL 60202-3439 | 2016-07-18 |
| 1396103230 | Gnogno Md Visiting Physician Group Inc. | Internal Medicine | 800 Austin St, 269e, Evanston, IL 60202-3439 | 2016-02-07 |
| 1255706131 | Presence Chicago Hospitals Network | Internal Medicine | 800 Austin St, Suite 207 West Tower, Evanston, IL 60202-3439 | 2015-12-03 |
| 1730566779 | Sonam Shokso | Nurse Practitioner | 800 Austin St, Suite 269, Evanston, IL 60202-3439 | 2015-04-29 |
| 1235574237 | Anshu Gupta, Md, P.C. | Internal Medicine | 800 Austin St, Suite 607, West Tower, Evanston, IL 60202-3439 | 2013-05-03 |
| 1447508874 | Mohamad Albsheri | Student in an Organized Health Care Education/Training Program | 800 Austin St, Evanston, IL 60202-3439 | 2012-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548889496 | Ktsmiles, Inc | Clinic/Center | 2408 Main Street, Evanston, IL 60202 | 2020-04-10 |
| 1831751163 | Dorcas Matowe | Marriage & Family Therapist | The Family Institute, 618 Library Place, Evanston, IL 60202 | 2019-07-08 |
| 1457847170 | Lilah Handler | Social Worker | 905 Forest Ave, Apt 1, Evanston, IL 60202 | 2018-07-05 |
| 1528574472 | Jessica Kubacki | Developmental Therapist | 535 Hinman Ave Apt F3, Evanston, IL 60202 | 2017-12-14 |
| 1376075853 | Lisa Meyerson Acupuncture | Acupuncturist | 1234 Sherman Avenue, Lighthouse Yoga and Acupuncture, Evanston, IL 60202 | 2017-04-03 |
| 1427597368 | Lillian Obucina Dds PC | Dentist | 111 North Wabash, Suite 1522, Chicago, IL 60202 | 2017-02-13 |
| 1184176893 | Amelia Willcox | Speech-Language Pathologist | 620 Sheridan Square, Apartment 1, Evanston, IL 60202 | 2016-10-28 |
| 1831547785 | Thomas Hagerty Jr. | Pharmacist | 2491 W Howard St, Evanston, IL 60202 | 2016-06-01 |
| 1013361948 | Autism Hope Support | In Home Supportive Care | 815 Seward Apt. 1s, Evanston, IL 60202 | 2016-04-18 |
| 1215302625 | Preferred Dentistry Associates, LLC | Dentist | 1029 Howard Street, Evanston, IL 60202 | 2015-12-10 |
| Find all providers in zip 60202 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699299313 | Bridges Habilitation Services, Inc. | Specialist | 1425 Highway 150 S Ste 2, Evanston, WY 82930-5377 | 2017-08-03 |
| 1689027609 | Adam Zastrow | Specialist | 834 Seward St Apt 1, Evanston, IL 60202-5322 | 2016-07-14 |
| 1366839912 | Marie Doyle | Specialist | 2203 Central St, Apt. 1, Evanston, IL 60201-5718 | 2015-04-21 |
| 1124433248 | Foundation for Medical Development In Central Europe Inc | Specialist | 1927 Sherman Ave Apt 3n, Evanston, IL 60201-3229 | 2014-06-26 |
| 1790109684 | Haley Zimmerman | Specialist | 2307 Central St Apt 2, Evanston, IL 60201-5730 | 2014-02-12 |
| 1497030068 | Jack Cooksey | Specialist | 2505 Lawndale Ave, Evanston, IL 60201-1157 | 2011-10-14 |
| 1376830240 | Megan Romero | Specialist | 2663 Prairie Ave, Apt 3, Evanston, IL 60201-5744 | 2011-06-29 |
| 1225330046 | Alison Lynn Velasco | Specialist | 2316 Prospect Ave., Evanston, IL 60201-1838 | 2010-11-30 |
| 1629382858 | Thomas J Chorba Md Sc | Specialist | 1101 Howard Street, Suite 105, Evanston, IL 60202 | 2010-07-29 |
| 1962737379 | Gwendolyn Mason Fiske | Specialist | 1047 Darrow Ave, Evanston, IL 60202 | 2009-10-03 |
| Find all providers in EVANSTON | ||||
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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.