Kastytis Alexander Jucas, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036-044413 Issued in IL

Practice address

3235 W 111TH St
Chicago, IL 60655-2730

Phone

(773) 233-0744

Fax

(773) 233-9416

NPI assigned

Jul 28, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609876952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552730",
            "telephone_number": "773-233-0744",
            "fax_number": "773-233-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 W 111TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606552730",
            "telephone_number": "773-233-0744",
            "fax_number": "773-233-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUCAS",
        "first_name": "KASTYTIS",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-044413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER #",
            "identifier": "21609421",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.