Active NPI
Joseph L Giacchino Jr., MD
- Family Medicine Physician
- Melrose Park, IL
National Provider Identifier
1306901400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 036050366
- Practice address
- 1252 Winston Plaza
Melrose Park, IL 60160 - Phone
- (708) 343-2500
- Fax
- (708) 343-9545
- NPI assigned
- Dec 27, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 036050366 | IL | Primary |
Addresses
Primary practice location
1252 Winston Plaza
Melrose Park, IL 60160
Mailing address
1252 Winston Plaza
Melrose Park, IL 60160
Phone (708) 343-2500
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16172816 | Other | IL | BLUE CROSS BLUE SHIELD |
| 036050366 | Medicaid | IL | |
| 738410 | Other | IL | MEDICARE |
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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036050366 | IL | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Melrose Park Clinic | Family Medicine | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Melrose Park, IL
- NPI 1578603023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212364800000",
"number": "1306901400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1252 WINSTON PLAZA",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "60160",
"telephone_number": "708-343-2500",
"fax_number": "708-343-9545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1252 WINSTON PLAZA",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "60160",
"telephone_number": "708-343-2500",
"fax_number": "708-343-9545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIACCHINO",
"first_name": "JOSEPH",
"middle_name": "L",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-27",
"last_updated": "2008-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IL",
"license": "036050366",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "16172816",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036050366",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "738410",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.