NPIMap

Individual provider Active NPI

John C Tricou, M.D.

  • Diagnostic Radiology Physician
  • Watseka, IL
National Provider Identifier
1447228036
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-078029 Issued in IL
Practice address
200 E Fairman Ave
Watseka, IL 60970-1644
Phone
(815) 432-7728
Fax
(815) 432-7827
NPI assigned
Mar 9, 2006
Last updated
Sep 26, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 036-078029 IL Primary

Addresses

Primary practice location

200 E Fairman Ave
Watseka, IL 60970-1644

Mailing address

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-7728

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
I20050505000833 IL Practitioner - Diagnostic Radiology 2264325513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-7728

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
17.17 of 100Reported as individual
Quality
28.5
Improvement activities
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-078029ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
John C Tricou MD LLC Diagnostic Radiology CurrentSince Sep 2, 2009 Accepting new patients
Advanced Midwest Radiology S C Diagnostic Radiology Past Accepting new patients

Locations

9410 Compubill Dr
Orland Park, IL 60462
Phone (312) 460-7444

200 E Fairman Ave
Watseka, IL 60970
Phone (815) 432-5201

Interoperability endpoints

  • Direct secure messaging: john.tricou.1@15486.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1447228036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "815-432-7728",
            "fax_number": "815-432-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "815-432-7728",
            "fax_number": "815-432-7827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRICOU",
        "first_name": "JOHN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-078029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watseka, IL

Sources for this page

Verify at the official NPI Registry.