Individual provider Active NPI

Joel P Villegas, MD

  • Internal Medicine Physician
  • Bourbonnais, IL
National Provider Identifier
1518063205
Registry record updated Apr 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036090542 Issued in IL
Practice address
370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914-5195
Phone
(815) 523-7020
Fax
(815) 523-7022
NPI assigned
Sep 16, 2006
Last updated
Apr 17, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2009

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 036090542 IL Primary

Addresses

Primary practice location

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914-5195

Mailing address

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914-5195
Phone (815) 523-7020

Other identifiers 2

IdentifierTypeStateIssuer
4632039OtherILBC GROUP NUMBER
36090542MedicaidIL

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
I20090827000671 IL Practitioner - Internal Medicine 4183778566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Internal Medicine, S.C.Group PAC ID 2668526047, 2 clinicians

Practice addresses (Care Compare)

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914-5193

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914-5195
Phone (815) 523-7020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036090542ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Internal Medicine, S.C. Internal Medicine CurrentSince Jun 1, 2009 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Riverside Health System Past Accepting new patients

Locations

370 Larry Power Rd
Bourbonnais, IL 60914
Phone (815) 523-7020

370 Larry Power Rd
Ste 2
Bourbonnais, IL 60914
Phone (815) 523-2070

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239926400000",
    "number": "1518063205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 LARRY POWER RD",
            "address_2": "SUITE 2",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145195",
            "telephone_number": "815-523-7020",
            "fax_number": "815-523-7022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 LARRY POWER RD",
            "address_2": "SUITE 2",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609145195",
            "telephone_number": "815-523-7020",
            "fax_number": "815-523-7022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEGAS",
        "first_name": "JOEL",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2009-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036090542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP NUMBER",
            "identifier": "4632039",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36090542",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourbonnais, IL

Sources for this page

Verify at the official NPI Registry.