Active NPI
Anthony M Fernandez, M.D.
- Family Medicine Physician
- Woodridge, IL
National Provider Identifier
1083796239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036109979
- Practice address
- 7409 Woodridge Dr
Woodridge, IL 60517-2249 - Phone
- (630) 241-1000
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036109979 | IL | Primary |
Addresses
Primary practice location
7409 Woodridge Dr
Woodridge, IL 60517-2249
Mailing address
1860 Paysphere Cir
Chicago, IL 60674-0018
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00714801 | Other | IL | RR MEDICARE |
| 036109979 | Medicaid | IL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1083796239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1860 PAYSPHERE CIR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606740018"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7409 WOODRIDGE DR",
"city": "WOODRIDGE",
"state": "IL",
"postal_code": "605172249",
"telephone_number": "630-241-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "ANTHONY",
"middle_name": "M",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036109979",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00714801",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036109979",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woodridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.