Organization Active NPI

Rogelio O Cave MD SC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1023277019
Registry record updated Jun 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036050538 Issued in IL
Legal business name
ROGELIO O CAVE MD SC
Practice address
67 W 111TH St
2ND Floor
Chicago, IL 60628-4247
Phone
(773) 995-3454
NPI assigned
Jun 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2008

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

Authorized official

Name
Rosita Doyle
Title
Billing Consultant
Phone
(773) 846-9521

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 036050538 IL Primary

Addresses

Primary practice location

67 W 111TH St
2ND Floor
Chicago, IL 60628-4247

Mailing address

9526 S Kilbourn Ave
Oak Lawn, IL 60453-3208
Phone (708) 422-3716

Other identifiers 3

IdentifierTypeStateIssuer
036050538-1MedicaidIL
21624903OtherILBLUECROSS BLUE SHIELD OF ILLINOIS
111910550OtherILRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

67 W 111th St
Fl 2
Chicago, IL 60628
Phone (773) 995-3454

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212537600000",
    "number": "1023277019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9526 S KILBOURN AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533208",
            "telephone_number": "708-422-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 W 111TH ST",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284247",
            "telephone_number": "773-995-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGELIO O CAVE MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-04",
        "last_updated": "2008-06-04",
        "status": "A",
        "authorized_official_last_name": "DOYLE",
        "authorized_official_first_name": "ROSITA",
        "authorized_official_title_or_position": "BILLING CONSULTANT",
        "authorized_official_telephone_number": "773-846-9521"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036050538",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036050538-1",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD OF ILLINOIS",
            "identifier": "21624903",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "111910550",
            "state": "IL"
        }
    ],
    "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 Jun 4, 2008; 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.