Organization Active NPI

William Piccione MD LLC

  • Vascular Surgery Physician
  • Oak Park, IL
National Provider Identifier
1740468545
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036074399 Issued in IL
Legal business name
WILLIAM PICCIONE MD LLC
Practice address
610 S Maple
Ste 2800
Oak Park, IL 60304-1091
Phone
(312) 563-4120
Fax
(312) 563-4127
NPI assigned
Feb 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Authorized official

Name
William PiccioneNPI 1982768461
Title
Owner
Phone
(312) 563-4120

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X 036074399 IL Primary

Addresses

Primary practice location

610 S Maple
Ste 2800
Oak Park, IL 60304-1091

Mailing address

610 S Maple
Ste 2800
Oak Park, IL 60304-1091
Phone (312) 563-4120

Other identifiers 1

IdentifierTypeStateIssuer
036074399MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040123000314 IL Part B Supplier - Clinic/Group Practice 9638071277 Receives reassigned benefits from 1 practitioner
Practice locations: Oak Park, IL; Wilmette, IL

National Provider Directory

National Provider Directory

Locations

610 S Maple Ave
Ste 2800
Oak Park, IL 60304
Phone (312) 563-4120

1000 Skokie Blvd
Ste 360
Wilmette, IL 60091
Phone (847) 256-8600

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369267200000",
    "number": "1740468545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S MAPLE",
            "address_2": "STE 2800",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041091",
            "telephone_number": "312-563-4120",
            "fax_number": "312-563-4127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S MAPLE",
            "address_2": "STE 2800",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603041091",
            "telephone_number": "312-563-4120",
            "fax_number": "312-563-4127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM PICCIONE MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2013-05-23",
        "status": "A",
        "authorized_official_last_name": "PICCIONE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-563-4120"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036074399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074399",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.