Active NPI
Purchit V Lacuesta, M.D.
- Family Medicine Physician
- Chicago, IL
National Provider Identifier
1003887423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036098775
- Practice address
- 7400 W Addison St
Chicago, IL 60634-3418 - Phone
- (773) 625-1900
- Fax
- (773) 625-5348
- NPI assigned
- Feb 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036098775 | IL | Primary |
Addresses
Primary practice location
7400 W Addison St
Chicago, IL 60634-3418
Mailing address
7400 W Addison St
Chicago, IL 60634-3418
Phone (773) 625-1900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00412094 | Other | RAILROAD MEDICARE |
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036098775 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Journeycare, Inc. | Family Medicine | Current | Accepting new patients |
| Journeycare, Inc | Family Medicine | Current | Accepting new patients |
| Addison Family Medicine LTD. | Family Medicine | Current | Accepting new patients |
| Marden B Lacuesta MD Inc | Family Medicine | Past | Accepting new patients |
Locations
7400 W Addison St
Chicago, IL 60634
Phone (773) 625-1900
2050 Claire Ct
Glenview, IL 60025
Phone (847) 467-7425
405 Lake Zurich Rd
North Barrington, IL 60010
Phone (847) 381-5599
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Chicago, IL
- NPI 1689551467
-
- Family Medicine Physician
- Celina, OH
- NPI 1811298342
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196035200000",
"number": "1003887423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7400 W ADDISON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606343418",
"telephone_number": "773-625-1900",
"fax_number": "773-625-5348"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7400 W ADDISON ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606343418",
"telephone_number": "773-625-1900",
"fax_number": "773-625-5348"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACUESTA",
"first_name": "PURCHIT",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-01",
"last_updated": "2007-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036098775",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00412094",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.