Active NPI
Noemi Villanueva, PA
- Physician Assistant
- Chicago, IL
National Provider Identifier
1649789967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.006348
- Practice address
- 4959 W Belmont Ave
Chicago, IL 60641-4332 - Phone
- (773) 930-3642
- NPI assigned
- Sep 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.006348 | IL | Primary |
Addresses
Primary practice location
4959 W Belmont Ave
Chicago, IL 60641-4332
Mailing address
3706 N Monticello Ave
Chicago, IL 60618-4118
Phone (773) 600-5677
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.006348 | IL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506643200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506643200000",
"number": "1649789967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3706 N MONTICELLO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606184118",
"telephone_number": "773-600-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4959 W BELMONT AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606414332",
"telephone_number": "773-930-3642"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLANUEVA",
"first_name": "NOEMI",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-29",
"last_updated": "2017-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.006348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.