Dr Evelyn G Basco MD, SC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036055675 Issued in IL

Legal business name

DR EVELYN G BASCO MD, SC

Practice address

3900 W Madison St
Chicago, IL 60624-2354

Phone

(773) 533-3440

Fax

(773) 884-8117

NPI assigned

Apr 24, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Lilyflor G Jose

Title

Adm Assist

Phone

(773) 737-8818

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Evelyn Ganaden Basco, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1669531679
  NPD (past)

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250035200000",
    "number": "1629243282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242354",
            "telephone_number": "773-533-3440",
            "fax_number": "773-884-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606242354",
            "telephone_number": "773-533-3440",
            "fax_number": "773-884-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR EVELYN G BASCO MD, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2009-08-12",
        "status": "A",
        "authorized_official_last_name": "JOSE",
        "authorized_official_first_name": "LILYFLOR",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADM ASSIST",
        "authorized_official_telephone_number": "773-737-8818",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "036055675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1235373853",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036055675",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; 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.