NPIMap

Individual provider Active NPI

Luciano Fochesatto Filho, M.D.

  • Internal Medicine Physician
  • Crestwood, IL
National Provider Identifier
1356591549
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036124456 Issued in IL
Practice address
13755 Cicero Ave
Crestwood, IL 60418
Phone
(708) 385-2400
Fax
(708) 385-8130
NPI assigned
Sep 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 036124456 IL
Internal Medicine Physician 207R00000X 036124456 IL Primary

Addresses

Primary practice location

13755 Cicero Ave
Crestwood, IL 60418

Mailing address

901 McClintock Dr
Suite 202
Burr Ridge, IL 60527-0844
Phone (888) 220-6432

Other identifiers 2

IdentifierTypeStateIssuer
201034520MedicaidIN
036124456MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101201000027 IL Practitioner - Internal Medicine 6406042522 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Morris HospitalGroup PAC ID 1850372459, 115 clinicians

Practice addresses (Care Compare)

150 W High St
Morris, IL 60450-1463
Phone (815) 942-2932

4640 Sassafras LN
Naperville, IL 60564-1139
Phone (312) 532-9821

901 McClintock Dr
Suite 202
Burr Ridge, IL 60527-0872
Phone (888) 220-6432

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036124456ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Morris Hospital CurrentSince Jan 15, 2024 Accepting new patients
Miinedoctor, Inc. Internal Medicine CurrentSince Feb 10, 2019 Accepting new patients
Asad Zaman MD SC Internal Medicine CurrentSince Apr 15, 2019 Accepting new patients
Morris Hospital CurrentSince Jan 15, 2024 Accepting new patients
Morris Hospital Current Accepting new patients
Blue Island HBP Medical Group LLC Internal Medicine Past Accepting new patients

Locations

13755 Cicero Ave
Crestwood, IL 60418
Phone (708) 385-2400

580 Sycamore St
Marseilles, IL 61341
Phone (815) 795-2122

725 School St
Ste A
Morris, IL 60450

150 W High St
Morris, IL 60450
Phone (815) 942-2129

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

Interoperability endpoints

  • Direct secure messaging: lfilho@yourcarecommunity.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1356591549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MCCLINTOCK DR",
            "address_2": "SUITE 202",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605270844",
            "telephone_number": "888-220-6432",
            "fax_number": "630-654-4253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13755 CICERO AVE",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "60418",
            "telephone_number": "708-385-2400",
            "fax_number": "708-385-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOCHESATTO FILHO",
        "first_name": "LUCIANO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-24",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "IL",
            "license": "036124456",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036124456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201034520",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036124456",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, IL

Sources for this page

Verify at the official NPI Registry.