Organization Active NPI

Valley West Medical Center, S.C.

  • Family Medicine Physician
  • Plano, IL
National Provider Identifier
1013191097
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
VALLEY WEST MEDICAL CENTER, S.C.
Practice address
1200 W South St
Plano, IL 60545-1790
Phone
(630) 552-7601
Fax
(630) 552-9215
NPI assigned
Dec 26, 2007
Last updated
May 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Authorized official

Name
Mr. Jose G. Trevino Sr., M.D.NPI 1609941319
Title
President
Phone
(630) 552-7601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

1200 W South St
Plano, IL 60545-1790

Mailing address

1200 W South St
Plano, IL 60545-1790
Phone (630) 552-7601

Other practice location 1

403 W Galena Blvd Ste 203
Aurora, IL 60506-3988
Phone (630) 897-0091

Other identifiers 2

IdentifierTypeStateIssuer
4722870OtherILBLUE CROSS/BLUE SHIELD
036061677MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080211000445 IL Part B Supplier - Clinic/Group Practice 4284717539 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0421971Valley West Medical Center SC1200 W South St, Plano, IL 60545Certificate of waiverApr 27, 2027

National Provider Directory

National Provider Directory

Locations

403 W Galena Blvd
Ste 203
Aurora, IL 60506
Phone (630) 552-7601

143 S Lincoln Ave
Ste H
Aurora, IL 60505
Phone (630) 897-0091

1200 W South St
Plano, IL 60545
Phone (630) 301-1769

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778803200000",
    "number": "1013191097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 W SOUTH ST",
            "city": "PLANO",
            "state": "IL",
            "postal_code": "605451790",
            "telephone_number": "630-552-7601",
            "fax_number": "630-552-9215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 W SOUTH ST",
            "city": "PLANO",
            "state": "IL",
            "postal_code": "605451790",
            "telephone_number": "630-552-7601",
            "fax_number": "630-552-9215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 W Galena Blvd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605063988",
            "country_code": "US",
            "telephone_number": "630-897-0091",
            "fax_number": "630-906-9336",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VALLEY WEST MEDICAL CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-26",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-552-7601",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "4722870",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061677",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.