Burgos Fuentes Service Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036103673 Issued in IL

Legal business name

BURGOS FUENTES SERVICE CORPORATION

Practice address

229 W Grand Ave Ste QW
Bensenville, IL 60106-3373

Phone

(630) 422-1917

Fax

(630) 422-7226

NPI assigned

Nov 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Miguel A Burgos, M.D.NPI 1013058379

Title

President

Phone

(630) 422-1917

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Miguel Burgos, M.D

  • Family Medicine Physician
  • Bensenville, IL
  • NPI 1013058379
  Medicare reassignment NPD Authorized official
• Mary G Burgos, O.D.

  • Optometrist
  • Elmhurst, IL
  • NPI 1982991980
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322697600000",
    "number": "1154491348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 W GRAND AVE STE QW",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601063373",
            "telephone_number": "630-422-1917",
            "fax_number": "630-422-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 W GRAND AVE STE QW",
            "city": "BENSENVILLE",
            "state": "IL",
            "postal_code": "601063373",
            "telephone_number": "630-422-1917",
            "fax_number": "630-422-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURGOS FUENTES SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2011-12-01",
        "status": "A",
        "authorized_official_last_name": "BURGOS",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-422-1917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036103673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Mary Bozek-Sheehan, MS, CCC-SLP
• Brentwood Family Dental
• Bridgeway of Bensenville Independent Living LLC
• Bridgeway Senior Living LLC
• Brookfield Podiatry Center
• Miguel Burgos, M.D
• Cecilie Butz
• Jason Alan Castator, M.D.
• Anna Crystal Chaidez, MD
• Vanessa Chimenti, BCBA

• Primary Care Clinic/Center in Bensenville, IL
• Providers in Bensenville, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.