Individual provider Active NPI

Januario Purisima Estrada III, M.D.

  • Internal Medicine Physician
  • Hoffman Estates, IL
National Provider Identifier
1356358873
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036074492 Issued in IL
Practice address
1585 Barrington Rd
#306
Hoffman Estates, IL 60194-1090
Phone
(847) 844-3199
Fax
(847) 844-1536
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036074492 IL Primary

Addresses

Primary practice location

1585 Barrington Rd
#306
Hoffman Estates, IL 60194-1090

Mailing address

PO Box 64568
Phoenix, AZ 85082-4568
Phone (630) 288-6200

Other identifiers 3

IdentifierTypeStateIssuer
036074492MedicaidIL
110196734OtherILRAILROAD MEDICARE
0021623344OtherILBCBS PROVIDER ID

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
036074492ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1356358873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64568",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850824568",
            "telephone_number": "630-288-6200",
            "fax_number": "855-781-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 BARRINGTON RD",
            "address_2": "#306",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601941090",
            "telephone_number": "847-844-3199",
            "fax_number": "847-844-1536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "JANUARIO",
        "middle_name": "PURISIMA",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036074492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036074492",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110196734",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER ID",
            "identifier": "0021623344",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.