Juanbosco Ayala, M.D.
Individual provider Active NPI Pulmonary Disease Physician · Chicago Ridge, IL
NPI 1497956981 · NPPES record last updated Jun 20, 2018
Key facts
- NPI
- 1497956981
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- 036117517 (IL)
- Practice address
- 10604 Southwest Highway
Ste 107
Chicago Ridge, IL 60415-2717 - Phone
- (708) 422-0636
- Fax
- (708) 424-2164
- NPI assigned
- May 30, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 13
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Midwest Pulmonary Critical Care and Sleep Consultants LLC
Practice addresses (Care Compare)
12820 S Ridgeland Ave
Suite B
Palos Heights, IL 60463-2389
Phone (708) 371-8006
Hospital & facility affiliations
- Osf Little Company of Mary Medical Center
- Saint Anthony Hospital
- Advocate Trinity Hospital
- Advocate Christ Hospital & Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110706000196 | IL | Practitioner - Pulmonary Disease |
1254420235 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.117517 | IL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Pulmonary Critical Care & Sleep Consultants LLC | Internal Medicine | Current |
Accepting new patients |
| Advocate Health and Hospitals Corporation | Past | Accepting new patients |
Locations
2875 W 19th St
Chicago, IL 60623
Phone (773) 484-4300
29777 Network Pl
Chicago, IL 60673
10604 Southwest Hwy
Ste 107
Chicago Ridge, IL 60415
Phone (708) 371-8006
10837 S Cicero Ave
Ste 300
Oak Lawn, IL 60453
Phone (419) 902-2161
12820 S Ridgeland Ave
Ste B
Palos Heights, IL 60463
Phone (708) 371-8006
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036.117517 | IL | |
| Pulmonary Disease Physician | 207RP1001X | 036117517 | IL | Yes |
Addresses
Primary practice location
10604 Southwest Highway
Ste 107
Chicago Ridge, IL 60415-2717
Mailing address
10604 Southwest Highway
Ste 107
Chicago Ridge, IL 60415-2717
Phone (708) 422-0636
Other providers in Chicago Ridge, IL
- Haleyur Arun
- Ascending Sprouts Pediatric Therapy, LLC
- Associated Urological Specialists LLC
- Hisham Atallah
- Liliana Lupita Avitia
- Courtney Bandemer
- Robin Louise Bauman
- Gina Berg
- Aaron D Berger
- Paul Robert Boone
All providers in Chicago Ridge, IL · Pulmonary Disease Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.