Individual provider Active NPI

Juan F Vargas-Montano, MD

  • Obstetrics & Gynecology Physician
  • Chicago, IL
National Provider Identifier
1205855020
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036-048889 Issued in IL
Practice address
1945 W Wilson Ave
Suite 2113
Chicago, IL 60640-5255
Phone
(773) 784-0851
Fax
(773) 769-3431
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036-048889 IL Primary

Addresses

Primary practice location

1945 W Wilson Ave
Suite 2113
Chicago, IL 60640-5255

Mailing address

PO Box 798
Park Ridge, IL 60068-0798
Phone (847) 692-6218

Other identifiers 1

IdentifierTypeStateIssuer
036048889MedicaidIL

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)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-048889ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Nephrology, S.C. Past Accepting new patients
Lakefront Medical Associates LLC Obstetrics & Gynecology Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/684/brand/2/csg/43/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302048000000",
    "number": "1205855020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 798",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600680798",
            "telephone_number": "847-692-6218",
            "fax_number": "847-692-5609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1945 W WILSON AVE",
            "address_2": "SUITE 2113",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405255",
            "telephone_number": "773-784-0851",
            "fax_number": "773-769-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS-MONTANO",
        "first_name": "JUAN",
        "middle_name": "F",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2011-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036-048889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036048889",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 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.

Verify at the official NPI Registry.