Individual provider Active NPI

Vladimir Victor Eugene, DMSC, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1245125780
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1 E Erie St Ste 525-2489
Chicago, IL 60611-2740
Phone
(224) 900-6463
NPI assigned
Jun 12, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X IL
Physician Assistant 363A00000X IL Primary

Addresses

Primary practice location

1 E Erie St Ste 525-2489
Chicago, IL 60611-2740

Mailing address

1 E Erie St Ste 525-2489
Chicago, IL 60611-2740
Phone (224) 900-6463

Other practice location 1

1860 W Winchester Rd Ste 106
Libertyville, IL 60048-5312
Phone (847) 816-6335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250807000910 IL Practitioner - Physician Assistant 2466950712 Reassigns benefits to 1 organization
I20250910003861 WI Practitioner - Physician Assistant 2466950712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1860 W Winchester Rd
Suite 106
Libertyville, IL 60048-5312
Phone (847) 816-6335

4600 Green Bay Rd
Kenosha, WI 53144-1719
Phone (847) 816-6335

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Peace of Mind Telehealth PLLC Medical Current Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Physician Assistant CurrentSince Jul 1, 2025 Accepting new patients
Ganesha Institute of Neurology and Psychiatry SC Physician Assistant CurrentSince Jul 1, 2025 Accepting new patients

Locations

1860 W Winchester Rd
Ste 106
Libertyville, IL 60048
Phone (847) 599-0715

1850 W Winchester Rd
Ste 115
Libertyville, IL 60048
Phone (847) 816-6335

4600 Green Bay Rd
Kenosha, WI 53144
Phone (847) 816-6335

Interoperability endpoints

  • Direct secure messaging: vladimir.eugene.1@9664.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1245125780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST STE 525-2489",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112740",
            "telephone_number": "224-900-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 E ERIE ST STE 525-2489",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112740",
            "telephone_number": "224-900-6463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1860 W Winchester Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600485312",
            "country_code": "US",
            "telephone_number": "847-816-6335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EUGENE",
        "first_name": "VLADIMIR",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "DMSC, PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.