Individual provider Active NPI

Virgilio Ilagan Jonson, MD

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1376561084
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036049533 Issued in IL
Practice address
11101 S State Street
Chicago, IL 60628-4206
Phone
(773) 821-7515
Fax
(773) 821-6970
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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 036049533 IL Primary

Addresses

Primary practice location

11101 S State Street
Chicago, IL 60628-4206

Mailing address

11101 S State Street
Chicago, IL 60628-4206
Phone (773) 821-7515

Other identifiers 1

IdentifierTypeStateIssuer
036049533MedicaidIL

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
036049533ILMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1376561084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11101 S STATE STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284206",
            "telephone_number": "773-821-7515",
            "fax_number": "773-821-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11101 S STATE STREET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606284206",
            "telephone_number": "773-821-7515",
            "fax_number": "773-821-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONSON",
        "first_name": "VIRGILIO",
        "middle_name": "ILAGAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036049533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049533",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2010; 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.