Individual provider Active NPI

Camille Enriquez, MD

  • Emergency Medicine Physician
  • Berwyn, IL
National Provider Identifier
1063969376
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036150100 Issued in IL
Practice address
3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone
(708) 783-9100
NPI assigned
Sep 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036150100 IL Primary

Addresses

Primary practice location

3249 Oak Park Ave
Berwyn, IL 60402-3429

Mailing address

3249 Oak Park Ave
Berwyn, IL 60402-3429

Other practice location 1

500 W Court St
Kankakee, IL 60901-3661
Phone (815) 937-2400

Other practice location 2

635 N Dearborn St Ste 100
Chicago, IL 60654-4618
Phone (312) 694-2273

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200806000439 IL Practitioner - Emergency Medicine 4880019934 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians
Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Practice addresses (Care Compare)

171 N Aberdeen St
Suite 100
Chicago, IL 60607-1669
Phone (312) 926-4150

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100

4732 N Lincoln Ave
Chicago, IL 60625-8561
Phone (847) 475-2273

635 N Dearborn St
Chicago, IL 60654-4618
Phone (312) 926-0404

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

  • Saint Francis Hospital-Evanston Hospital, Evanston, IL, CCN 140080
  • Presence St Marys Hospital Hospital, Kankakee, IL, CCN 140155
  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054
  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281

Merit-based Incentive Payment System (MIPS)

Final score
93.41 of 100Reported as group
Quality
86.81
Improvement activities
40
Cost
77.34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036150100ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Dec 1, 2024 Accepting new patients
Cepamerica Illinois LLP Emergency Medicine Current Accepting new patients
Cepamerica Illinois LLP Emergency Medicine CurrentSince Jul 1, 2020 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Dec 1, 2024 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations (25 of 34)

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

600 S Randall Rd
Algonquin, IL 60102
Phone (224) 783-4300

2635 Church Rd
Ste 101
Aurora, IL 60502
Phone (630) 315-6900

820 S State Route 59
Ste A
Bartlett, IL 60103
Phone (630) 483-5930

820 S State Route 59
Bartlett, IL 60103
Phone (630) 213-9600

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

231 S Gary Ave
Ste 100
Bloomingdale, IL 60108
Phone (630) 893-9600

Dept 5777
Carol Stream, IL 60122

171 N Aberdeen St
Ste 100
Chicago, IL 60607
Phone (312) 694-2273

4445 W Irving Park Rd
Ste 110
Chicago, IL 60641
Phone (312) 921-0417

4732 N Lincoln Ave
Chicago, IL 60625
Phone (312) 926-0536

1135 S Delano Ct E
Ste B201
Chicago, IL 60605
Phone (312) 694-2500

1333 W Belmont Ave
Ste 100
Chicago, IL 60657
Phone (312) 693-2273

360 Station Dr
Ste 300A
Crystal Lake, IL 60014
Phone (815) 788-7500

350 S Waukegan Rd
Ste 150
Deerfield, IL 60015
Phone (312) 926-3107

1425 N Randall Rd
Elgin, IL 60123
Phone (224) 783-5437

1630 Sherman Ave
Ste 130
Evanston, IL 60201
Phone (224) 271-4400

885 Roosevelt Rd
Ste 100
Glen Ellyn, IL 60137
Phone (630) 384-6200

2701 Patriot Blvd
Ste 110
Glenview, IL 60026
Phone (312) 694-2273

6155 Grand Ave
Ste 100
Gurnee, IL 60031
Phone (224) 271-6700

10350 Haligus Rd
Ste A
Huntley, IL 60142
Phone (815) 455-6100

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

525 Rockland Rd
Ste 100
Lake Bluff, IL 60044
Phone (847) 475-2273

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

2507 N Richmond Rd
Ste B
McHenry, IL 60051
Phone (815) 206-7500

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 4

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": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1063969376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023429",
            "telephone_number": "708-783-9100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Court St",
            "address_purpose": "LOCATION",
            "city": "Kankakee",
            "state": "IL",
            "postal_code": "609013661",
            "country_code": "US",
            "telephone_number": "815-937-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "635 N Dearborn St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606544618",
            "country_code": "US",
            "telephone_number": "312-694-2273",
            "fax_number": "312-694-2129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "CAMILLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-02",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036150100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.