Organization Active NPI

My Doc S.C.

  • Primary Care Clinic/Center
  • Chicago, IL
National Provider Identifier
1376746198
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036094011 Issued in IL
Legal business name
MY DOC S.C.
Practice address
2403 S Oakley Ave
Chicago, IL 60608
Phone
(773) 376-0160
Fax
(773) 376-0350
NPI assigned
Jun 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Authorized official

Name
Lillian Foca-Munoz, M.D.NPI 1518173152
Title
Owner
Phone
(773) 376-0160

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036094011 IL Primary

Addresses

Primary practice location

2403 S Oakley Ave
Chicago, IL 60608

Mailing address

2403 S Oakley Ave
Chicago, IL 60608-4901
Phone (773) 376-0160

Other practice location 1

2315 W Belmont Ave
Chicago, IL 60618-6422
Phone (773) 325-0811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070906000418 IL Part B Supplier - Clinic/Group Practice 2860585908 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1070060My Doc S C - Lillian Foca-Munoz2403 S Oakley Ave, #1, Chicago, IL 60608Certificate of waiverJun 19, 2027

National Provider Directory

National Provider Directory

Locations

2403 S Oakley Ave
Chicago, IL 60608
Phone (773) 376-0160

2315 W Belmont Ave
Chicago, IL 60618
Phone (773) 325-0811

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544745600000",
    "number": "1376746198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2403 S OAKLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084901",
            "telephone_number": "773-376-0160",
            "fax_number": "773-376-0350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2403 S OAKLEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60608",
            "telephone_number": "773-376-0160",
            "fax_number": "773-376-0350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2315 W Belmont Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606186422",
            "country_code": "US",
            "telephone_number": "773-325-0811",
            "fax_number": "773-348-6531",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY DOC S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2018-12-14",
        "status": "A",
        "authorized_official_last_name": "FOCA-MUNOZ",
        "authorized_official_first_name": "LILLIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-376-0160",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036094011",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.