NPIMap

Individual provider Active NPI

Eveline Faith Tan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Wheaton, IL
National Provider Identifier
1295731370
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
016004847 Issued in IL
Practice address
2001 S Wiesbrook Rd
Wheaton, IL 60189
Phone
(630) 614-4000
Fax
(630) 614-4048
NPI assigned
Jun 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 016004847 IL Primary

Addresses

Primary practice location

2001 S Wiesbrook Rd
Wheaton, IL 60189

Mailing address

2001 S Wiesbrook Rd
Wheaton, IL 60189-7813
Phone (630) 614-4000

Other identifiers 3

IdentifierTypeStateIssuer
K37096OtherILMEDICARE PTAN (INDIVIDUAL)
592050OtherILMEDICARE PTAN (GROUP)
P00448606OtherILRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041028000459 IL Practitioner - Podiatry 8820050222 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

2001 S Wiesbrook Rd
Wheaton, IL 60189-7813
Phone (630) 614-4000

2635 Church Rd
Suite 101
Aurora, IL 60502-8943
Phone (630) 315-6900

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

Hospital & facility affiliations

  • Northwestern Medicine Delnor Community Hospital Hospital, Geneva, IL, CCN 140211
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
95.63 of 100Reported as apm
Quality
88.47
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue57
Removal of skin lesions34
Removal of nail tissue51

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016004847ILMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Jul 1, 2018 Accepting new patients
Central Dupage Physician Group CurrentSince Jul 1, 2018 Accepting new patients

Locations

Carol Stream, IL 60122
Phone (630) 933-3300

Dept 5777
Carol Stream, IL 60122

351 Delnor Dr
Ste 300
Geneva, IL 60134
Phone (630) 262-1001

351 Delnor Dr
Ste 410
Geneva, IL 60134
Phone (630) 232-6354

351 Delnor Dr
Geneva, IL 60134
Phone (630) 262-1001

636 Raymond Dr
Ste 100
Naperville, IL 60563
Phone (630) 548-3366

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

2001 S Wiesbrook Rd
Wheaton, IL 60189
Phone (630) 510-7666

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

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 3

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": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1295731370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S WIESBROOK RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601897813",
            "telephone_number": "630-614-4000",
            "fax_number": "630-614-4048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WIESBROOK RD",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "60189",
            "telephone_number": "630-614-4000",
            "fax_number": "630-614-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "EVELINE",
        "middle_name": "FAITH",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-23",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016004847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (INDIVIDUAL)",
            "identifier": "K37096",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (GROUP)",
            "identifier": "592050",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00448606",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.