Active NPI
Richard Anthony Jorgensen, M.D.
- Surgery Physician
- Wheaton, IL
National Provider Identifier
1013197250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Practice address
- 1028 Gary CT
Wheaton, IL 60187-4000 - Phone
- (630) 710-7008
- NPI assigned
- Nov 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | IL | Primary |
Addresses
Primary practice location
1028 Gary CT
Wheaton, IL 60187-4000
Mailing address
1028 Gary CT
Wheaton, IL 60187-4000
Phone (630) 710-7008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-062282 | IL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1194220800000",
"number": "1013197250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1028 GARY CT",
"city": "WHEATON",
"state": "IL",
"postal_code": "601874000",
"telephone_number": "630-710-7008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1028 GARY CT",
"city": "WHEATON",
"state": "IL",
"postal_code": "601874000",
"telephone_number": "630-710-7008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORGENSEN",
"first_name": "RICHARD",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-05",
"last_updated": "2007-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wheaton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.