Individual provider Active NPI

Stacey L Oaks, DPM

  • Podiatrist
  • Chicago, IL
National Provider Identifier
1063425361
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016005295 Issued in IL
Practice address
259 E Erie St FL 13
Chicago, IL 60611-3926
Phone
(312) 695-6800
NPI assigned
Aug 15, 2006
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016005295 IL
Podiatrist 213E00000X 016005295 IL Primary

Addresses

Primary practice location

259 E Erie St FL 13
Chicago, IL 60611-3926

Mailing address

259 E Erie St FL 13
Chicago, IL 60611-3926
Phone (312) 695-6800

Other identifiers 3

IdentifierTypeStateIssuer
016005295MedicaidIL
P00732457OtherILRAILROAD MEDICARE
001621735OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Dr. Stacey L Bielinski Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080214000148 IL Practitioner - Podiatry 0648353631 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue48
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016005295ILMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2019 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jan 1, 2019 Accepting new patients
Pam Eernisse DPM SC Foot & Ankle Surgery CurrentSince Aug 1, 2015 Accepting new patients
Pam Eernisse DPM SC Podiatrist CurrentSince Aug 1, 2015 Accepting new patients
Central Dupage Physician Group Past Accepting new patients
Jondelle Jenkins Podiatrist Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

30 N Michigan Ave
Ste 720
Chicago, IL 60602
Phone (312) 701-0770

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

259 E Erie St
Fl 13
Chicago, IL 60611

9050 W 81st St
Ste 500
Justice, IL 60458
Phone (312) 375-4788

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

9050 W 81st St
Oak Lawn, IL 60458
Phone (708) 563-0330

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1063425361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST FL 13",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113926",
            "telephone_number": "312-695-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST FL 13",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113926",
            "telephone_number": "312-695-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OAKS",
        "first_name": "STACEY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016005295",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016005295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016005295",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00732457",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "001621735",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STACEY",
            "last_name": "BIELINSKI",
            "middle_name": "L",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.