Create a Find a Doctor Profile

To begin creating your Find a Doctor profile, please complete the form below.

General Information

First Name (Required)

Last Name (Required)

Credentials (Required)

M.D.
D.O.
Other

Email Address (Required)

Primary Specialty (Required)

Are You Employed by Swedish Medical Group? (Required)

Yes
No

Are You Part of NorthShore Medical Group? (Required)

Yes
No

NPI Number (Required)

Board Certification (Required)

Yes
No
Board Eligible

Gender

Male
Female

Languages Spoken (In Addition to English)

Start Date

Education

Graduate School

Medical School

Medical Residency

Fellowship

Additional Education

Clinical Information

What Year Did You Begin Practicing? (Required)

Primary Clinical Focus

Do You Treat Children? (Please Select All That Apply)

Children Under Ten
Children Over Ten
I Do Not Treat Children

Clinical Interests (List Up to 10)

Patient Philosophy

Would You Like to Receive Patient Referrals Through the Call Center's Provider Referral Service? (Required)

Yes
No

If No, Is It Because You Are Not Accepting New Patients? (Required)

Yes
No

Office Location One

Address

Phone

Fax

Hours

Office Location Two

Address

Phone

Fax

Hours

Marketing Opportunities

Do You Have a Physician Website? (Include URL Below)

Can We Add It to Your Physician Profile?

Yes
No

Would You Like Be Listed in SCH's Online Directory? (Required)

Yes
No

Would You Like to Schedule a New Professional Headshot? (Required)

Yes
No

Verified Patient Reviews Now Available

Endeavor Health Medical Group provider profiles now have patient ratings and comments to help you make informed decisions about the providers you choose.

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For Health Care Professionals

Create a Find a Doctor Profile

General Information

Education

Clinical Information

Office Location One

Office Location Two

Marketing Opportunities

Verified Patient Reviews Now Available

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