Ronald Mochizuki, M.D.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036078225 Issued in IL

Practice address

12251 S 80TH Ave
Palos Heights, IL 60463-1256

Phone

(708) 923-5055

Fax

(708) 923-5058

NPI assigned

Oct 11, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251244800000",
    "number": "1083602270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 388320",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606388320",
            "telephone_number": "773-767-8283",
            "fax_number": "773-767-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-5055",
            "fax_number": "708-923-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOCHIZUKI",
        "first_name": "RONALD",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2009-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036078225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036078225",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "01620954",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "250008036",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Candice Morales

• Gastroenterology Physician in Palos Heights, IL
• Providers in Palos 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 Aug 26, 2009; 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.