Individual provider Active NPI

Erik B. Pauls, PA-C

  • Physician Assistant
  • Skokie, IL
National Provider Identifier
1174530968
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085002787 Issued in IL
Practice address
9977 Woods Dr FL 1
Skokie, IL 60077-1057
Phone
(224) 364-2273
Fax
(847) 663-8290
NPI assigned
Aug 2, 2006
Last updated
May 29, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085002787 IL Primary

Addresses

Primary practice location

9977 Woods Dr FL 1
Skokie, IL 60077-1057

Mailing address

9977 Woods Dr FL 1
Skokie, IL 60077-1057
Phone (224) 364-2273

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080718000622 IL Practitioner - Physician Assistant 3072686344 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

1162 W Maple Ave
Mundelein, IL 60060-1438
Phone (847) 367-2400

1329 N Wolf Rd
Mount Prospect, IL 60056-1500
Phone (847) 803-3040

1535 Ellinwood Ave
Des Plaines, IL 60016-4553
Phone (224) 364-2273

211 Waukegan Rd
Suite 200
Northfield, IL 60093-2724
Phone (847) 767-3718

2650 Ridge Ave
Evanston, IL 60201-1700

4901 Searle Pkwy
Suite 150
Skokie, IL 60077-1057

501 Skokie Blvd
Northbrook, IL 60062-2802
Phone (847) 504-2300

71 Waukegan Rd
Suite 700
Lake Bluff, IL 60044-1614
Phone (224) 364-2273

920 Milwaukee Ave
Lincolnshire, IL 60069-3839
Phone (847) 866-7846

9977 Woods Dr
Skokie, IL 60077-1057
Phone (847) 663-8062

9977 Woods Dr 2ND Floor
Skokie, IL 60077-1057
Phone (847) 663-8370

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085002787ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Winfield Pathology Consultants, S.C. Current Accepting new patients
Central Dupage Hospital Association CurrentSince Mar 2, 2016 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Endeavor Health Clinical Operations Past Accepting new patients

Locations

25 N Winfield Rd
Winfield, IL 60190
Phone (630) 682-1600

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, 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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1174530968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR FL 1",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273",
            "fax_number": "847-663-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9977 WOODS DR FL 1",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771057",
            "telephone_number": "224-364-2273",
            "fax_number": "847-663-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULS",
        "first_name": "ERIK",
        "middle_name": "B.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.