Individual provider Active NPI

Romeo Lagrosa, MD

  • Family Medicine Physician
  • Niles, IL
National Provider Identifier
1316079593
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Practice address
8965 W Golf Rd
Niles, IL 60714-5812
Phone
(847) 795-8600
Fax
(847) 795-8602
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X IL Primary

Addresses

Primary practice location

8965 W Golf Rd
Niles, IL 60714-5812

Mailing address

1 Tiffany PT
Suite G-18
Bloomingdale, IL 60108-2936
Phone (630) 980-8410

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

LicenseStateTypeSpecialty
036065190ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Doctors Network LLC Past Accepting new patients
Omega Community Healthcare Organization Inc. Past Accepting new patients

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201824000000",
    "number": "1316079593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TIFFANY PT",
            "address_2": "SUITE G-18",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082936",
            "telephone_number": "630-980-8410",
            "fax_number": "630-980-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8965 W GOLF RD",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607145812",
            "telephone_number": "847-795-8600",
            "fax_number": "847-795-8602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGROSA",
        "first_name": "ROMEO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2008-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.

Verify at the official NPI Registry.