Individual provider Active NPI

Eliseo Rosel Roquiz Jr., D.O.

  • Family Medicine Physician
  • Naperville, IL
National Provider Identifier
1124339833
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036131705 Issued in IL
Practice address
640 S Washington St
350
Naperville, IL 60540-6603
Phone
(630) 717-2646
NPI assigned
Jun 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036131705 IL Primary

Addresses

Primary practice location

640 S Washington St
350
Naperville, IL 60540-6603

Mailing address

1860 Paysphere Cir
Chicago, IL 60674-0018

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eroquiz35463@direct.edward.org

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
I20130731000792 IL Practitioner - Family Practice 4981845005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dupage Medical Group LTDGroup PAC ID 5496667941, 1,326 clinicians

Practice addresses (Care Compare)

640 S Washington
Suite 268
Naperville, IL 60540-6694
Phone (630) 961-2710

Hospital & facility affiliations

  • Residential Home Health Home health agency, Lisle, IL, CCN 147568

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Medical Group LTD CurrentSince Aug 12, 2013 Accepting new patients
Dupage Medical Group LTD CurrentSince Aug 12, 2013 Accepting new patients

Locations

30 Stratford Dr
Bloomingdale, IL 60108
Phone (630) 893-2210

1860 Paysphere Cir
Chicago, IL 60674
Phone (630) 469-2000

640 S Washington St
Ste 268
Naperville, IL 60540
Phone (630) 961-2710

640 S Washington St
Ste 350
Naperville, IL 60540
Phone (630) 596-0060

640 S Washington St
Naperville, IL 60540
Phone (630) 428-1500

Interoperability endpoints

  • Direct secure messaging: eroquiz35463@dulyhealthandcare.direct-ci.com

Organizations & group practices 2

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 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": "1277683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1124339833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 PAYSPHERE CIR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606740018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S WASHINGTON ST",
            "address_2": "350",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406603",
            "telephone_number": "630-717-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUIZ",
        "first_name": "ELISEO",
        "middle_name": "ROSEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-28",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036131705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eroquiz35463@direct.edward.org",
            "affiliation": "N",
            "address_1": "640 S Washington St",
            "address_2": "350",
            "city": "Naperville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "605406603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.