Active NPI
Victor Cimino, MD, DDS
- Plastic and Reconstructive Surgery Physician
- Park Ridge, IL
National Provider Identifier
1194792911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 36091195
- Practice address
- 22 S Washington Ave
Park Ridge, IL 60068-4267 - Phone
- (847) 268-3910
- Fax
- (708) 327-3463
- NPI assigned
- Mar 1, 2006
- Last updated
- Jun 8, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 021002374 | IL | |
| Plastic and Reconstructive Surgery Physician | 2086S0122X | 36091195 | IL | Primary |
Addresses
Primary practice location
22 S Washington Ave
Park Ridge, IL 60068-4267
Mailing address
22 S Washington Ave
Park Ridge, IL 60068-4267
Phone (847) 268-3910
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Plastic and Reconstructive Surgery
- Education
- State University of New York at Buffalo School of Medicine, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-8372
22 S Washington Ave
Park Ridge, IL 60068-4267
Phone (847) 268-3910
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Mastectomy | 1-10 |
| Melanoma (skin cancer) excision | 21 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 021002374 | IL | MD | Oral and Maxillofacial Surgery (Dentist) |
| 36091195 | IL | MD | Plastic and Reconstructive Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chicago Surgical Specialists, LLC | Oral and Maxillofacial Surgery | Current | Accepting new patients |
| Loyola University Physician Foundation | Past | Accepting new patients | |
| The Iowa Clinic PC | Past | Accepting new patients | |
| The Iowa Clinic, PC | Past | Accepting new patients | |
| Northwest Plastic Surgeons | Past | Accepting new patients |
Locations
22 S Washington Ave
Park Ridge, IL 60068
Phone (847) 268-3910
Organizations & group practices 6
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.
-
- Oral and Maxillofacial Surgery (Dentist)
- Park Ridge, IL
- NPI 1235560178
-
- General Practice Physician
- Maywood, IL
- NPI 1336159961
-
- General Practice Physician
- Maywood, IL
- NPI 1235148891
-
- Plastic Surgery Physician
- Arlington Heights, IL
- NPI 1972658714
-
- Durable Medical Equipment & Medical Supplies
- West Des Moines, IA
- NPI 1871451328
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Melrose Park, IL
- NPI 1831170232
-
dba Foster G. McGaw Hospital
- General Acute Care Hospital
- Maywood, IL
- NPI 1376521575
-
dba Loyola University Medical Center Cancer Center
- General Acute Care Hospital
- Tinley Park, IL
- NPI 1427752013
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591574400000",
"number": "1194792911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 S WASHINGTON AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600684267",
"telephone_number": "847-268-3910",
"fax_number": "847-897-3118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 S WASHINGTON AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600684267",
"telephone_number": "847-268-3910",
"fax_number": "708-327-3463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CIMINO",
"first_name": "VICTOR",
"name_prefix": "Dr.",
"credential": "MD, DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-01",
"last_updated": "2020-06-08",
"certification_date": "2020-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "IL",
"license": "021002374",
"primary": false
},
{
"code": "2086S0122X",
"taxonomy_group": "",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "IL",
"license": "36091195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.