MAYUGA MEDICAL PRACTICE NPI 1396789053

NPI Information

  • NPI: 1396789053
  • Provider Name: MAYUGA MEDICAL PRACTICE
  • Classification: Internal Medicine - 207RC0000X
  • Specialization: Cardiovascular Disease
  • Entity Type: Organization
  • Address: 2800 N SHERIDAN RD
    SUITE303
    CHICAGO, IL
    ZIP 60657
  • Phone: (773) 281-7660

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NPI Details

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
1207RC0000XInternal MedicineCardiovascular Disease036075687ILLINOISYes

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
1036075687MEDICAIDILLINOIS
201605124OTHERILLINOISBLUE CROSS BLUE SHIELD IL
3200943MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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: 11/21/2025

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