Jack Glenn Huguley, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

085003674 Issued in IL

Practice address

811 South State Street
Suiteb
Chicago, IL 60605-0000

Phone

(312) 566-9510

Fax

(312) 566-9511

NPI assigned

Feb 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Vepema Medical Group

  • Emergency Medicine Physician
  • Turlock, CA
  • NPI 1356502496
  NPD (past)

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265760000000",
    "number": "1649244336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 544",
            "address_2": "DEPT 5390",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532010544",
            "telephone_number": "815-713-2600",
            "fax_number": "815-654-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 SOUTH STATE STREET",
            "address_2": "SUITEB",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606050000",
            "telephone_number": "312-566-9510",
            "fax_number": "312-566-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUGULEY",
        "first_name": "JACK",
        "middle_name": "GLENN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2010-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "CA",
            "license": "PA16498",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL PA LICENSE",
            "identifier": "085003674",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary Hunter Hughes, MD
• Melanie Hughey
• Robert Hughey, MD
• Hugo H Muriel MDSC
• Erica Ester Hugo Lin, PHARM.D.
• Grace Kim Huh, PSYD
• Hae Jung Huh, M.D.
• In Huh, M.D.
• Noah Joon Huh
• Richard Huh, M.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2010; 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.