Kristin Nicole Vercillo, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

036-137521 Issued in IL

Practice address

890 Garfield Ave
Libertyville, IL 60048-4723

Phone

(847) 816-7495

Fax

(847) 816-7497

NPI assigned

Jun 16, 2010

Last updated

Feb 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

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

Colorectal Surgery (Proctology)Also: General Surgery

Education

University of Pittsburgh School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, 3,081 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Condell Medical Center Hospital, Libertyville, IL, CCN 140202

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kvercillo234409@direct.myadvocateaurora.org

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.

• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment Care Compare group NPD
• Advocate Health & Hospitals Corporation

  dba Advocate Christ Medical Group

  • Medical Specialty Clinic/Center
  • Oak Lawn, IL
  • NPI 1912936014
  NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Advocate Condell Medical Center

  dba Advocate Condell Imaging Center

  • Mobile Mammography Clinic/Center
  • Gurnee, IL
  • NPI 1023262441

  Hospital

  Care Compare affiliation
• Advocate Condell Medical Center

  • General Acute Care Hospital
  • Libertyville, IL
  • NPI 1124272547
  Care Compare affiliation
• Advocate Condell Medical Center

  dba Advocate Condell Medical Center Grays Lake

  • Mobile Mammography Clinic/Center
  • Grayslake, IL
  • NPI 1770737199

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1346561123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 GARFIELD AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600484723",
            "telephone_number": "847-816-7495",
            "fax_number": "847-816-7497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1870 W Winchester Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600485365",
            "country_code": "US",
            "telephone_number": "847-816-7495 x20",
            "fax_number": "847-239-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERCILLO",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125-057837",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "IL",
            "license": "036-137521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kvercillo234409@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1870 W Winchester Rd Ste 112",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485365",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1870 W Winchester Rd Ste 112",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600485365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Gregory Vayl, CRNA
• Tracy Vazquez
• Angela Vega, APRN
• Sara R Vegh, M.D.
• Sally Ventura
• Ellen Verlen, APRN
• Vernon Hills Medical Center, LTD
• Susan Uilani Versino, PT
• Anthony Vicini
• Austin Videlka

• Colon & Rectal Surgery Physician in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Colon & Rectal Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.