Individual provider Active NPI

Aljon Mark Duterte Dumalagan, RN

  • Registered Nurse
  • Waukegan, IL
National Provider Identifier
1427875079
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041429730 Issued in IL
Practice address
1311 N McAree Rd
Waukegan, IL 60085-1426
Phone
(773) 633-1971
NPI assigned
Sep 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041429730 IL Primary
Registered Nurse 163W00000X 847791 NV

Addresses

Primary practice location

1311 N McAree Rd
Waukegan, IL 60085-1426

Mailing address

1311 N McAree Rd
Waukegan, IL 60085-1426
Phone (773) 633-1971

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041429730ILMDRegistered Nurse
847791NVMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1727136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1427875079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 N MCAREE RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600851426",
            "telephone_number": "773-633-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N MCAREE RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600851426",
            "telephone_number": "773-633-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMALAGAN",
        "first_name": "ALJON MARK",
        "middle_name": "DUTERTE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-24",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041429730",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NV",
            "license": "847791",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukegan, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.