Active NPI
Salvatore Ventura, MD
- Nephrology Physician
- Blue Island, IL
National Provider Identifier
1306843040
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 036068579
- Practice address
- 12200 Western Ave Ste 120
Blue Island, IL 60406-3507 - Phone
- (708) 388-0499
- Fax
- (708) 388-0283
- NPI assigned
- Jul 7, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 036068579 | IL | Primary |
Addresses
Primary practice location
12200 Western Ave Ste 120
Blue Island, IL 60406-3507
Mailing address
120 W 22ND St Ste 200
Oak Brook, IL 60523-1563
Phone (630) 573-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036068579 | Medicaid | IL | |
| 1616108 | Other | IL | BCBS |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | credentialing@nephdocs.com | ||
| Direct Messaging Address | sventura276377@direct.myadvocateaurora.org | Direct | |
| FHIR URL | https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100126000742 | IL | Practitioner - Nephrology | 6204720022 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- sventura276377@direct.myadvocateaurora.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674518400000",
"number": "1306843040",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 W 22ND ST STE 200",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231563",
"telephone_number": "630-573-5000",
"fax_number": "630-491-5472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12200 WESTERN AVE STE 120",
"city": "BLUE ISLAND",
"state": "IL",
"postal_code": "604063507",
"telephone_number": "708-388-0499",
"fax_number": "708-388-0283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENTURA",
"first_name": "SALVATORE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-07",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "IL",
"license": "036068579",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036068579",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "1616108",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "credentialing@nephdocs.com",
"affiliation": "N",
"address_1": "120 W 22nd St Ste 200",
"city": "Oak Brook",
"state": "IL",
"country_code": "US",
"postal_code": "605231563",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "sventura276377@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "12200 Western Ave Ste 120",
"city": "Blue Island",
"state": "IL",
"country_code": "US",
"postal_code": "604063507",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicfhir.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "12200 Western Ave Ste 120",
"city": "Blue Island",
"state": "IL",
"country_code": "US",
"postal_code": "604063507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Blue Island, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.