MAYUGA MEDICAL PRACTICE NPI 1396789053

NPI Information

NPI: 1396789053
Provider Name: MAYUGA MEDICAL PRACTICE
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
2800 N SHERIDAN RD
SUITE303
CHICAGO, IL
ZIP 60657
Phone: (773) 281-7660
Get Directions

MAYUGA MEDICAL PRACTICE is a cardiovascular disease internal medicine in Chicago, IL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. MAYUGA MEDICAL PRACTICE NPI is 1396789053. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2800 N SHERIDAN RD
SUITE303
CHICAGO, IL
ZIP 60657-156
Phone: (773) 281-7660

The provider's authorized official is Ruperto Mayuga .
The authorized official title is President and has the following contact phone number (773) 281-7660.

The enumeration date for this NPI number is 6/15/2006 and was last updated on 3/25/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	036075687	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	036075687	MEDICAID	ILLINOIS
2	01605124	OTHER	ILLINOIS	BLUE CROSS BLUE SHIELD IL
3	200943	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »