Active NPI
Michael S Vercillo, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Warrenville, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 036.130263
- Practice address
- 4405 Weaver Pkwy
Warrenville, IL 60555-3269 - Phone
- (630) 352-5450
- Fax
- (630) 938-8849
- NPI assigned
- Aug 10, 2008
- Last updated
- Jun 30, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 036.130263 | IL | Primary |
Addresses
Primary practice location
4405 Weaver Pkwy
Warrenville, IL 60555-3269
Mailing address
4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 352-5450
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
- Thoracic Surgery
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1000 N Westmoreland Rd
Pavillion B 3Rd FL
Lake Forest, IL 60045-1659
Phone (847) 535-8500
1000 Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600
1475 E Belvidere Rd
Grayslake, IL 60030-2012
600 N Westmoreland Rd
Suite 1100
Lake Forest, IL 60045-1659
Phone (847) 535-9510
660 N Westmoreland Rd
Lake Forest, IL 60045-1659
Phone (847) 234-5600
660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146
675 N Saint Clair St
Chicago, IL 60611-5975
675 N St Clair
Chicago, IL 60611-5975
800 N W Moreland Rd
Suite 102
Lake Forest, IL 60045-1687
Phone (847) 582-2104
800 N Westmoreland Rd
Suite 201
Lake Forest, IL 60045-1687
Phone (847) 535-7647
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper gastrointestinal (GI) endoscopy for acid reflux | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.130263 | IL | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Northwestern Medical Faculty Foundation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Central Dupage Physician Group | Current | Accepting new patients | |
| Advocate Health & Hospitals Corporation | Current | Accepting new patients |
Locations
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
Carol Stream, IL 60122
Phone (630) 933-3300
Dept 5777
Carol Stream, IL 60122
29373 Network Pl
Chicago, IL 60673
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870
1700 Luther Ln
Ste 1110
Park Ridge, IL 60068
Phone (630) 402-1463
4405 Weaver Pkwy
Warrenville, IL 60555
Phone (630) 352-5450
1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045
Organizations & group practices 7
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.
-
dba Northwestern Medical Group
- Multi-Specialty Clinic/Center
- Carol Stream, IL
- NPI 1346235314
-
dba Advocate Medical Group
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
dba Northwestern Medicine Regional Medical Group
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
-
dba Advocate Christ Medical Group
- Medical Specialty Clinic/Center
- Oak Lawn, IL
- NPI 1912936014
-
dba Advocate Children's Hospital
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
dba Northwestern Medicine Regional Medical Group
- Orthopaedic Surgery Physician
- Geneva, IL
- NPI 1780012344
-
dba Northwestern Medical Group
- Durable Medical Equipment & Medical Supplies
- Chicago, IL
- NPI 1417718479
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Centegra Hospital McHenry
- General Acute Care Hospital
- McHenry, IL
- NPI 1982611281
-
dba Northwestern Medicine Lake Forest Hospital
- General Acute Care Hospital
- Lake Forest, IL
- NPI 1124025176
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1497859649
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625011200000",
"number": "1598911505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4405 WEAVER PKWY",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605553269",
"telephone_number": "630-352-5450",
"fax_number": "630-938-8849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4405 WEAVER PKWY",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "605553269",
"telephone_number": "630-352-5450",
"fax_number": "630-938-8849"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERCILLO",
"first_name": "MICHAEL",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-10",
"last_updated": "2021-06-30",
"certification_date": "2021-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "IL",
"license": "036.130263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Warrenville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.