WILLIAM CRUIKSHANK (M.D.) – Internal Medicine Physician, NPI 1639104052
Internal Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for WILLIAM CRUIKSHANK (M.D.)
100 W 162nd St
South Holland, IL 604732003
Phone: (708) 730-2200
Type: Location
2231 E 95th St
Chicago, IL 606174804
Phone: (773) 768-7700
Type: Location
1395 NW 167TH ST
MIAMI GARDENS, FL 331695710
Phone: (773) 768-7700
Type: Mailing
6101 W 95TH ST
OAK LAWN, IL 604532735
Phone: (708) 261-0831
Type: Location
West 22nd Street, Oak Brook, DuPage County, Illinois, 60521, United States
SUITE 202
OAK BROOK, IL 605231225
Phone: (630) 320-1160
Type: Mailing
100, West 162nd Street, South Holland, Thornton Township, Cook County, Illinois, 60473, United States
SOUTH HOLLAND, IL 604732003
Phone: (708) 730-2200
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-04-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040423000615 | I | Internal Medicine | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60473)
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