Individual provider Active NPI

Eugene M Tanquilut, DO

  • Vascular Surgery Physician
  • Olympia Fields, IL
National Provider Identifier
1043215148
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036094341 Issued in IL
Practice address
20060 Governors Dr
Suite 102
Olympia Fields, IL 60461-1029
Phone
(815) 824-4406
Fax
(815) 844-0307
NPI assigned
Jun 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 036094341 IL Primary
Vascular Surgery Physician 2086S0129X 02002492A IN

Addresses

Primary practice location

20060 Governors Dr
Suite 102
Olympia Fields, IL 60461-1029

Mailing address

20060 Governors Dr
Suite 102
Olympia Fields, IL 60461-1029
Phone (815) 824-4406

Other practice location 1

555 W Court St
Kankakee, IL 60901-3664
Phone (815) 824-4406

Other identifiers 1

IdentifierTypeStateIssuer
036094341MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050603000938 IN Practitioner - Vascular SurgeryPractitioner - General Surgery 6406846658 Reassigns benefits to 1 organization
I20061208000233 IL Practitioner - Vascular SurgeryPractitioner - General Surgery 6406846658 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vascular Specialists LLCGroup PAC ID 1153551494, 5 clinicians

Practice addresses (Care Compare)

1912 45TH St
Munster, IN 46321-3917
Phone (815) 824-4406

8505 183Rd St
Suite a
Tinley Park, IL 60487-9354
Phone 8158244406128

Hospital & facility affiliations

  • Advocate Trinity Hospital Hospital, Chicago, IL, CCN 140048
  • Franciscan Health Olympia & Chicago Heights Hospital, Olympia Fields, IL, CCN 140172
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Advocate Christ Hospital & Medical Center Hospital, Oak Lawn, IL, CCN 140208
  • Silver Cross Hospital and Medical Centers Hospital, New Lenox, IL, CCN 140213

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal30
Leg revascularization (restoring blood flow)35
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036094341ILMDVascular Surgery Physician
02002492AINMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Aug 1, 2010 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Aug 1, 2010 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Vascular Specialists of Indiana LLC Vascular Surgery CurrentSince Oct 9, 2022 Accepting new patients
Vascular Specialists LLC Vascular Surgery CurrentSince Jan 1, 2014 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

333 Dixie Hwy
Chicago Hts, IL 60411
Phone (708) 756-0100

900 Garfield Ave
Libertyville, IL 60048
Phone (847) 362-2900

4440 W 95th St
Ste 108
Oak Lawn, IL 60453
Phone (708) 684-3966

3800 W 203rd St
Ste 202
Olympia Fields, IL 60461
Phone (708) 679-2010

4001 Vollmer Rd
Olympia Flds, IL 60461
Phone (708) 481-8883

20060 Governors Dr
Ste 102
Olympia Flds, IL 60461
Phone (219) 736-8896

8505 183rd St
Ste A
Tinley Park, IL 60487
Phone (815) 824-4406

1912 45th St
Munster, IN 46321
Phone (219) 922-8710

Interoperability endpoints

  • Direct secure messaging: etanquilut763010@direct.franciscanalliance.org
  • Direct secure messaging: eugene.tanquilut.1@16383.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1043215148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20060 GOVERNORS DR",
            "address_2": "SUITE 102",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611029",
            "telephone_number": "815-824-4406",
            "fax_number": "815-844-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20060 GOVERNORS DR",
            "address_2": "SUITE 102",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611029",
            "telephone_number": "815-824-4406",
            "fax_number": "815-844-0307"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 W Court St",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609013664",
            "country_code": "US",
            "telephone_number": "815-824-4406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANQUILUT",
        "first_name": "EUGENE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-15",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036094341",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IN",
            "license": "02002492A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094341",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

Verify at the official NPI Registry.