Individual provider Active NPI

Jorge Valentin Figueredo, M.D.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1447353230
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036058621 Issued in IL
Practice address
1634 W Warren Blvd
Chicago, IL 60612-3224
Phone
(708) 269-8162
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01067070A IN
Surgery Physician 208600000X 036058621 IL
General Practice Physician 208D00000X 036058621 IL
Family Medicine Physician 207Q00000X 036058621 IL Primary

Addresses

Primary practice location

1634 W Warren Blvd
Chicago, IL 60612-3224

Mailing address

1634 W Warren Blvd
Chicago, IL 60612-3224
Phone (708) 269-8162

Other identifiers 2

IdentifierTypeStateIssuer
036058621MedicaidIL
P00115376OtherR/R MEDICARE

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

LicenseStateTypeSpecialty
036058621ILMDFamily Medicine Physician
01067070AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southside Community Hospital, Inc. Past Accepting new patients
Centra Health Inc Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1447353230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1634 W WARREN BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123224",
            "telephone_number": "708-269-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 W WARREN BLVD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123224",
            "telephone_number": "708-269-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIGUEREDO",
        "first_name": "JORGE",
        "middle_name": "VALENTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01067070A",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036058621",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036058621",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036058621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036058621",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "P00115376",
            "state": null
        }
    ],
    "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 Feb 22, 2021; 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.