Phillip Leon Cacioppo, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

800 Biesterfield Rd
Wimmer BLDG. Suite 202
Elk Grove Village, IL 60007-3311

Phone

(847) 806-0106

Fax

(847) 806-9323

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Specialty

General SurgeryAlso: Vascular Surgery

Education

Loyola University of Chicago, Stritch School of Medicine, 1967

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Shore Vein Clinics LLC 3 clinicians

Vein Clinics of Chicago LLC 9 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• North Shore Vein Clinics LLC

  • Vascular Surgery Physician
  • Northbrook, IL
  • NPI 1841547098

  IL

  Medicare reassignment Care Compare group
• Vein Clinics of Chicago LLC

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1386904621

  IL

  Medicare reassignment Care Compare group
• Illinois Phlebology Associates SC

  • Surgery Physician
  • Orland Park, IL
  • NPI 1154378040

  IL

  Medicare reassignment NPD
• USA Vascular Centers of Chicago, LLC

  • Vascular Surgery Physician
  • Northbrook, IL
  • NPI 1174995674

  IL

  Medicare reassignment NPD
• Congress Vascular Center LLC

  • Vascular Surgery Physician
  • Chicago, IL
  • NPI 1396267324

  IL

  Medicare reassignment
• Congress Vein Clinic LLC

  • Trauma Surgery Physician
  • Chicago, IL
  • NPI 1467986901

  IL

  Medicare reassignment
• Northwest Vein Clinics LLC

  • Vascular Surgery Physician
  • Elk Grove Village, IL
  • NPI 1578810651

  IL

  Medicare reassignment
• Elmwood Park Vascular Center LLC

  • Vascular Surgery Physician
  • Elmwood Park, IL
  • NPI 1043731300
  NPD (past)
• Premiere Anesthesia Group LLC

  • Certified Registered Nurse Anesthetist
  • Park Ridge, IL
  • NPI 1720467392
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198108800000",
    "number": "1184759136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "WIMMER BLDG. SUITE 202",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-806-0106",
            "fax_number": "847-806-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD",
            "address_2": "WIMMER BLDG. SUITE 202",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073311",
            "telephone_number": "847-806-0106",
            "fax_number": "847-806-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CACIOPPO",
        "first_name": "PHILLIP",
        "middle_name": "LEON",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "31602106",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0361047981",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "461632",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joanne Amelie Brutus-Nwokorie
• Emily Budo, CRNA
• Courtney Burns
• Alexandria Byrne
• Paloma Cabrera
• Ellisia Calvin
• Lakisha Y Cameron
• Kristin Camorlinga, LPC
• Theresa Campbell, PH.D.
• Kara Christine Canga-Arguelles, L.AC., M.S.O.M.,B.S.

• All providers in Elk Grove Village, IL
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.