Individual provider Active NPI

Steven J Deangeles, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1467438630
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036082732 Issued in IL
Practice address
200 S Michigan Ave
Suite 830
Chicago, IL 60604-2402
Phone
(312) 922-2500
Fax
(312) 922-2523
NPI assigned
Dec 20, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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 036082732 IL Primary

Addresses

Primary practice location

200 S Michigan Ave
Suite 830
Chicago, IL 60604-2402

Mailing address

200 S Michigan Ave
Suite 830
Chicago, IL 60604-2402
Phone (312) 922-2500

Other identifiers 1

IdentifierTypeStateIssuer
036082732MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2006 through Jul 1, 2028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036082732ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1467438630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 S MICHIGAN AVE",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606042402",
            "telephone_number": "312-922-2500",
            "fax_number": "312-922-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S MICHIGAN AVE",
            "address_2": "SUITE 830",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606042402",
            "telephone_number": "312-922-2500",
            "fax_number": "312-922-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELES",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-20",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036082732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036082732",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.