| Johnathan Au, MD, MPH | |
| 2650 Ridge Ave., Dept. Of Radiology, Evanston, IL 60201 | |
| (847) 570-2486 | |
| Not Available | 
| Full Name | Johnathan Au | 
|---|---|
| Gender | Male | 
| Speciality | Radiology - Diagnostic Radiology | 
| Location | 2650 Ridge Ave., Evanston, Illinois | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1518463231 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 83034-20 (Wisconsin) | Secondary | 
| 2085R0202X | Radiology - Diagnostic Radiology | 036163315 (Illinois) | Primary | 
| 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 | 
| Entity Name | Gbr Sheboygan Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1467529917 PECOS PAC ID: 1951341064 Enrollment ID: O20240208001165 | 
| Entity Name | Green Bay Radiology Sc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1447327986 PECOS PAC ID: 7113908310 Enrollment ID: O20240314000576 | 
| Entity Name | Radiology Associates Of The Fox Valley Sc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1477539443 PECOS PAC ID: 0446152748 Enrollment ID: O20240417001507 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Johnathan Au, MD, MPH 2650 Ridge Ave., Dept. Of Radiology, Evanston, IL 60201 Ph: (847) 570-2486 | Johnathan Au, MD, MPH 2650 Ridge Ave., Dept. Of Radiology, Evanston, IL 60201 Ph: (847) 570-2486 | 
| Dr. Daniel K. West, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Department Of Radiology, G507, Evanston, IL 60201 Phone: 847-570-2475 Fax: 847-570-2942 | |
| Joel Bernstein, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 2650 Ridge Ave, Evanston Hospital, Evanston, IL 60201 Phone: 847-570-1206 Fax: 847-570-1248 | |
| Dr. Marc J Alonzo, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Department Of Radiology, G507, Evanston, IL 60201 Phone: 847-570-2475 Fax: 847-570-2942 | |
| Ali Abbas Al-saraf, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston, IL 60201 Phone: 847-570-2477 | |
| Anupam Basu, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave, Evanston Hospital, Evanston, IL 60201 Phone: 847-570-2000 | |
| Dr. Joseph Michael Montalbano, MD Radiology Medicare: May Accept Medicare Assignments Practice Location: 2650 Ridge Ave, Department Of Radiology, G507, Evanston, IL 60201 Phone: 847-570-2475 Fax: 847-570-2942 | |
| Jacob Seth Ecanow, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2650 Ridge Ave., Department Of Radiology, Evanston, IL 60201 Phone: 847-570-2475 Fax: 847-570-2942 |