Active NPI
Villa Medical Arts
- Internal Medicine Physician
- Villa Park, IL
National Provider Identifier
1124058029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- VILLA MEDICAL ARTS
- Practice address
- 33 S. Villa Ave.
Suite 2
Villa Park, IL 60181 - Phone
- (630) 832-9000
- Fax
- (630) 832-7907
- NPI assigned
- Jul 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Deepa Fulton
- Title
- Practice Manager
- Phone
- (630) 832-9000
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
33 S. Villa Ave.
Suite 2
Villa Park, IL 60181
Mailing address
33 S. Villa Ave.
Suite 2
Villa Park, IL 60181
Phone (630) 832-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0416770 | Villa Medical Arts | Certificate of waiver | Mar 13, 2027 |
National Provider Directory
National Provider DirectoryLocations
33 S Villa Ave
Villa Park, IL 60181
Phone (630) 832-9000
33 S Villa Ave
Ste 2
Villa Park, IL 60181
Phone (630) 832-9000
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Villa Park, IL
- NPI 1427034073
-
- Family Medicine Physician
- Villa Park, IL
- NPI 1548258197
-
- Internal Medicine Physician
- Villa Park, IL
- NPI 1932197597
-
- Internal Medicine Physician
- Villa Park, IL
- NPI 1760470314
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1647993600000",
"number": "1124058029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 S. VILLA AVE.",
"address_2": "SUITE 2",
"city": "VILLA PARK",
"state": "IL",
"postal_code": "60181",
"telephone_number": "630-832-9000",
"fax_number": "630-832-7907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 S. VILLA AVE.",
"address_2": "SUITE 2",
"city": "VILLA PARK",
"state": "IL",
"postal_code": "60181",
"telephone_number": "630-832-9000",
"fax_number": "630-832-7907"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VILLA MEDICAL ARTS",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-04",
"last_updated": "2022-03-23",
"certification_date": "2022-03-23",
"status": "A",
"authorized_official_last_name": "FULTON",
"authorized_official_first_name": "DEEPA",
"authorized_official_title_or_position": "PRACTICE MANAGER",
"authorized_official_telephone_number": "630-832-9000"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Villa Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.