| Dr Doug Valassis Jr, MD | |
|
2650 Ridge Ave, Emergency Medicine, Evanston, IL 60201-1718 | |
| (847) 570-2114 | |
| (847) 570-1223 |
| Full Name | Dr Doug Valassis Jr |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Experience | 13 Years |
| Location | 2650 Ridge Ave, Evanston, Illinois |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245599489 | NPI | - | NPPES |
| 036136990 | Other | IL | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 036136990 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northshore University Healthsystem - Evanston Hospital | Evanston, IL | Hospital |
| Northwestern Lake Forest Hospital | Lake forest, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Endeavor Health Medical Group | 2163334699 | 3022 |
| Northwestern Medical Faculty Foundation | 4587576814 | 3871 |
| Entity Name | Northwestern Medical Faculty Foundation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346235314 PECOS PAC ID: 4587576814 Enrollment ID: O20031105000541 |
| Entity Name | Endeavor Health Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1497701882 PECOS PAC ID: 2163334699 Enrollment ID: O20040524000118 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Doug Valassis Jr, MD 2650 Ridge Ave, Professional Staff Office, Evanston, IL 60201-1718 Ph: (847) 570-2040 | Dr Doug Valassis Jr, MD 2650 Ridge Ave, Emergency Medicine, Evanston, IL 60201-1718 Ph: (847) 570-2114 |
Michael T. Gillam, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2650 Ridge Ave, Emergency Medicine Rm G909, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223 | |
Evan G Laskaris, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Division Of Emergency Medicine, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223 | |
Irene C. Yao, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2114 | |
Korie Lynne Zink, MD, MS Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223 | |
Yudith Diaz Baez, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223 | |
Isaac Kolawole Agboola, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223 | |
Wilber P. Yep, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2650 Ridge Ave, Emergency Medicine Rm G909, Evanston, IL 60201 Phone: 847-570-2114 Fax: 847-570-1223 |