Active NPI
Gustavo Ricardo Sanchez-Vargas, M.D.
- Family Medicine Physician
- Aurora, IL
National Provider Identifier
1205965522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036098710
- Practice address
- 523 W Galena Blvd
Aurora, IL 60506-3847 - Phone
- (630) 966-9701
- Fax
- (630) 966-9702
- NPI assigned
- Mar 4, 2007
- Last updated
- May 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 036098710 | IL | Primary |
Addresses
Primary practice location
523 W Galena Blvd
Aurora, IL 60506-3847
Mailing address
523 W Galena Blvd
Aurora, IL 60506-3847
Phone (630) 966-9701
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4526065 | Other | IL | BLUE CROSS BLUE SHIELD |
| 11308130 | Other | IL | CAQH |
| 036098710 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036098710 | IL | MD | Family Medicine Physician |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Aurora, IL
- NPI 1255514089
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1205965522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "523 W GALENA BLVD",
"city": "AURORA",
"state": "IL",
"postal_code": "605063847",
"telephone_number": "630-966-9701",
"fax_number": "630-966-9702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "523 W GALENA BLVD",
"city": "AURORA",
"state": "IL",
"postal_code": "605063847",
"telephone_number": "630-966-9701",
"fax_number": "630-966-9702"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANCHEZ-VARGAS",
"first_name": "GUSTAVO",
"middle_name": "RICARDO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-04",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036098710",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "4526065",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "11308130",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036098710",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.