Active NPI
Paul Arquilla, O.D.
- Optometrist
- Homewood, IL
National Provider Identifier
1013073436
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Practice address
- 825 Maple Ave
Homewood, IL 60430-2031 - Phone
- (708) 745-0660
- NPI assigned
- Dec 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | IL | Primary |
Addresses
Primary practice location
825 Maple Ave
Homewood, IL 60430-2031
Mailing address
12551 Haas Dr
Palos Park, IL 60464-2565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1636916 | Other | IL | BLUE CROSS BLUE SHIELD IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
825 Maple Ave
Homewood, IL 60430-2031
Phone (708) 798-2030
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-008539 | IL | MD | Optometrist |
Networks
- devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
- devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
- IL PPO Downstate
- devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
- IL HMO C-SNP
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Optometrist
- Homewood, IL
- NPI 1548389190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205280000000",
"number": "1013073436",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12551 HAAS DR",
"city": "PALOS PARK",
"state": "IL",
"postal_code": "604642565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 MAPLE AVE",
"city": "HOMEWOOD",
"state": "IL",
"postal_code": "604302031",
"telephone_number": "708-745-0660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARQUILLA",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-29",
"last_updated": "2008-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD IL",
"identifier": "1636916",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Homewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.