Organization Active NPI

Manuel O Rojas

  • Primary Care Clinic/Center
  • Chicago, IL
National Provider Identifier
1225338379
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036049646 Issued in IL
Legal business name
MANUEL O ROJAS
Doing business as
MANUEL O ROJAS
Practice address
4254 W 55TH St
Chicago, IL 60632-4642
Phone
(773) 582-5200
Fax
(773) 582-2772
NPI assigned
Oct 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Dr. Manuel O Rojas, MD
Title
Owner
Phone
(773) 582-5200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036049646 IL Primary
Primary Care Clinic/Center 261QP2300X 036103907 IL
Primary Care Clinic/Center 261QP2300X 036117332 IL

Addresses

Primary practice location

4254 W 55TH St
Chicago, IL 60632-4642

Mailing address

4254 W 55TH St
Chicago, IL 60632-4642
Phone (773) 582-5200

Other identifiers 3

IdentifierTypeStateIssuer
036049646MedicaidIL
036117332MedicaidIL
036103907MedicaidIL

Other names 1

  • MANUEL O ROJAS Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1225338379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4254 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324642",
            "telephone_number": "773-582-5200",
            "fax_number": "773-582-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4254 W 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324642",
            "telephone_number": "773-582-5200",
            "fax_number": "773-582-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL O ROJAS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "ROJAS",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-582-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036049646",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036103907",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036117332",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049646",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117332",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103907",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MANUEL O ROJAS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 22, 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.