Active NPI
Patricia J Valassis, M.D.
- Pediatrics Physician
- West Chicago, IL
National Provider Identifier
1407012743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036-126009
- Practice address
- 946 N Neltnor Blvd
Suite 120
West Chicago, IL 60185-5959 - Phone
- (630) 717-2300
- NPI assigned
- Aug 6, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036-126009 | IL | Primary |
Addresses
Primary practice location
946 N Neltnor Blvd
Suite 120
West Chicago, IL 60185-5959
Mailing address
636 Raymond Dr
Suite 205
Naperville, IL 60563-9789
Phone (630) 717-2300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036126009 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036-126009 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dupage Medical Group LTD | Past | 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.
-
dba DuPage Medical Group
- Multi-Specialty Clinic/Center
- Downers Grove, IL
- NPI 1801833983
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384473600000",
"number": "1407012743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "636 RAYMOND DR",
"address_2": "SUITE 205",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605639789",
"telephone_number": "630-717-2300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "946 N NELTNOR BLVD",
"address_2": "SUITE 120",
"city": "WEST CHICAGO",
"state": "IL",
"postal_code": "601855959",
"telephone_number": "630-717-2300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALASSIS",
"first_name": "PATRICIA",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-06",
"last_updated": "2013-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036-126009",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036126009",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.