Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Hanna Marie Kingstad

Individual provider Surgical Physician Assistant · NPI 1366176612

Hanna Marie Kingstad is a Physician Assistant in Evanston, Illinois. Qualified in 2023, 3 years ago. Practices with Endeavor Health Medical Group, a 3,348-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
3
Licensed in
IL
In the registry since
2022
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Practice location Address checks out

2650 Ridge Ave Walgreen 3507
Evanston, IL 60201-1718
Phone: (847) 570-2827
Fax: (847) 733-5005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 085010156 (IL)

Record details

NPI number1366176612
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 13, 2022
Last updated in NPPESFebruary 6, 2024
Certification dateFebruary 5, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Endeavor Health Medical Group — 3348 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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