Individual provider Active NPI

Milagros Villalobos, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1356366454
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036115882 Issued in IL
Practice address
3248 W North Ave
Chicago, IL 60647-4939
Phone
(773) 489-5440
Fax
(773) 489-5460
NPI assigned
Jul 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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 036115882 IL Primary

Addresses

Primary practice location

3248 W North Ave
Chicago, IL 60647-4939

Mailing address

3248 W North Ave
Chicago, IL 60647-4939
Phone (773) 489-5440

Other identifiers 2

IdentifierTypeStateIssuer
036115882MedicaidIL
1636530OtherILBLUE CROSS BLUE SHIELD

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
I20061113000188 IL Practitioner - Family Practice 6901804608

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036115882ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Milagros Villalobos, MD SC Family Medicine PastSince Sep 1, 2006 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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479081600000",
    "number": "1356366454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3248 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474939",
            "telephone_number": "773-489-5440",
            "fax_number": "773-489-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3248 W NORTH AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606474939",
            "telephone_number": "773-489-5440",
            "fax_number": "773-489-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLALOBOS",
        "first_name": "MILAGROS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2016-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036115882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036115882",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1636530",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.