Individual provider Active NPI

Eileen Anne Vicaldo Alonto, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1326290677
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036151087 Issued in IL
Practice address
820 S Damen Ave.
Chicago, IL 60612
Phone
(312) 569-6043
Fax
(701) 234-7230
NPI assigned
Oct 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 12202 ND
Internal Medicine Physician 207R00000X 036151087 IL Primary

Addresses

Primary practice location

820 S Damen Ave.
Chicago, IL 60612

Mailing address

820 S Damen Ave.
Chicago, IL 60612
Phone (312) 569-6043

Other identifiers 1

IdentifierTypeStateIssuer
16715MedicaidND

Other names 1

  • Eileen Anne Rimando Vicaldo Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210609001395 IL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 2769642115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1224201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1326290677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-569-6043",
            "fax_number": "312-569-8788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 S DAMEN AVE.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60612",
            "telephone_number": "312-569-6043",
            "fax_number": "701-234-7230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALONTO",
        "first_name": "EILEEN ANNE",
        "middle_name": "VICALDO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-17",
        "last_updated": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ND",
            "license": "12202",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036151087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16715",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EILEEN ANNE",
            "last_name": "VICALDO",
            "middle_name": "RIMANDO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.