Individual provider Active NPI

Jacqueline P Arteaga, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1396922357
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036119408 Issued in IL
Practice address
1845 W 47TH St
Chicago, IL 60609
Phone
(773) 927-5524
Fax
(773) 804-8450
NPI assigned
Jan 22, 2008
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 036119408 IL Primary

Addresses

Primary practice location

1845 W 47TH St
Chicago, IL 60609

Mailing address

100 E 14TH St Apt 904
Chicago, IL 60605-3666
Phone (773) 927-5524

Other identifiers 1

IdentifierTypeStateIssuer
11922552OtherCAQH

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
I20080417000065 IL Practitioner - Internal Medicine 0648358515 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036119408ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Center, LTD Internal Medicine CurrentSince Jul 1, 2009 Accepting new patients
Associates in Nephrology, S.C. PastSince Jul 1, 2009 Accepting new patients

Locations

1845 W 47th St
Chicago, IL 60609
Phone (773) 459-7862

6959 S Pulaski Rd
Chicago, IL 60629
Phone (773) 498-4201

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1396922357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E 14TH ST APT 904",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053666",
            "telephone_number": "773-927-5524",
            "fax_number": "773-804-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 W 47TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60609",
            "telephone_number": "773-927-5524",
            "fax_number": "773-804-8450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARTEAGA",
        "first_name": "JACQUELINE",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036119408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11922552",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.