K.a. Jucas M.D., S.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036044413 Issued in IL

Legal business name

K.A. JUCAS M.D., S.C.

Practice address

3235 W 111TH St
Chicago, IL 60655-2730

Phone

(773) 233-0744

Fax

(773) 233-9416

NPI assigned

Mar 17, 2010

Last updated

Mar 17, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kastytis A Jucas, M.D.NPI 1609876952

Title

President

Phone

(773) 233-0744

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kastytis Alexander Jucas, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1609876952
  Authorized official Same address or phone

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

{
    "created_epoch": "1268784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268784000000",
    "number": "1144544305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552730",
            "telephone_number": "773-233-0744",
            "fax_number": "773-233-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552730",
            "telephone_number": "773-233-0744",
            "fax_number": "773-233-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K.A. JUCAS M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-17",
        "last_updated": "2010-03-17",
        "status": "A",
        "authorized_official_last_name": "JUCAS",
        "authorized_official_first_name": "KASTYTIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-233-0744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036044413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER #",
            "identifier": "21609421",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "468361",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; 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.