Individual provider Active NPI

Vicente Cardenas, M.D

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1417025842
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036103295 Issued in IL
Practice address
1431 N Western Ave Ste 503
Chicago, IL 60622-1774
Phone
(773) 772-9121
NPI assigned
Dec 1, 2006
Sex
Male
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
Family Medicine Physician 207Q00000X 036103295 IL Primary

Addresses

Primary practice location

1431 N Western Ave Ste 503
Chicago, IL 60622-1774

Mailing address

2032 W Cermak Rd
Chicago, IL 60608-4116
Phone (773) 247-8855

Other practice location 1

809 N Western Ave
Chicago, IL 60622-4637
Phone (773) 772-9121

Other practice location 2

2032 W Cermak Rd
Chicago, IL 60608-4116
Phone (773) 247-8855

Other identifiers 1

IdentifierTypeStateIssuer
036103295MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vcardenas29176@ce-direct.presencehealth.org

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
I20100723000034 IL Practitioner - Family Practice 4082746227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare Illinois Medical Group LLCGroup PAC ID 5597275685, 278 clinicians

Practice addresses (Care Compare)

100 N River Rd
Des Plaines, IL 60016-1209
Phone (847) 297-1800

1431 N Western Ave
Suite 134
Chicago, IL 60622-1797
Phone (773) 235-1915

1431 N Western Ave
Suite 503
Chicago, IL 60622-1774
Phone (773) 772-9121

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Illinois Medical Group LLC Family Medicine CurrentSince Jun 7, 2025 Accepting new patients

Locations

1801 W Olympic Blvd
#2636
Pasadena, CA 91199

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

100 Provena Way
Ste 103
Bourbonnais, IL 60914
Phone (815) 937-8780

809 N Western Ave
Chicago, IL 60622
Phone (312) 772-9121

1431 N Western Ave
Ste 503
Chicago, IL 60622
Phone (773) 489-7979

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

201 N Hammes Ave
Joliet, IL 60435
Phone (224) 273-6350

Interoperability endpoints

  • Direct secure messaging: vicente.cardenas.p9@direct.athleticoltd.nextgenshare.com
  • Direct secure messaging: vcardenas29176@ce-direct.presencehealth.org

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.

Hospital & facility affiliations 4

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1417025842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2032 W CERMAK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084116",
            "telephone_number": "773-247-8855",
            "fax_number": "773-247-8896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE STE 503",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221774",
            "telephone_number": "773-772-9121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 N Western Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606224637",
            "country_code": "US",
            "telephone_number": "773-772-9121",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2032 W Cermak Rd",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606084116",
            "country_code": "US",
            "telephone_number": "773-247-8855",
            "fax_number": "773-247-8896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "VICENTE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2023-03-07",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103295",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vcardenas29176@ce-direct.presencehealth.org",
            "affiliation": "N",
            "address_1": "1431 N Western Ave Ste 503",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606221774",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.