Eduardo Villa, M.D., S.C.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

36074074 Issued in IL

Legal business name

EDUARDO VILLA, M.D., S.C.

Practice address

622 N Milwaukee Ave
Prospect Heights, IL 60070-2353

Phone

(847) 520-4887

Fax

(847) 520-4936

NPI assigned

Dec 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Eduardo De Jesus Villa, MD

Title

President

Phone

(847) 520-4887

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1013190289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5471 RFD",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600478211",
            "telephone_number": "847-520-4887",
            "fax_number": "847-520-4936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 N MILWAUKEE AVE",
            "city": "PROSPECT HEIGHTS",
            "state": "IL",
            "postal_code": "600702353",
            "telephone_number": "847-520-4887",
            "fax_number": "847-520-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDUARDO VILLA, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "VILLA",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "DE JESUS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-520-4887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "36074074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NA643303",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Gastroenterology Physician in Prospect Heights, IL
• Providers in Prospect Heights, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.