Individual provider Active NPI

Patricia J Tagamolila, MD

  • Obstetrics & Gynecology Physician
  • Arlington Heights, IL
National Provider Identifier
1659404945
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
036110233 Issued in IL
Practice address
1051 W Rand Rd Ste 101
Arlington Heights, IL 60004-2315
Phone
(847) 221-4900
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036110233 IL Primary

Addresses

Primary practice location

1051 W Rand Rd Ste 101
Arlington Heights, IL 60004-2315

Mailing address

720 S Brom
S104
Naperville, IL 60540
Phone (630) 717-9977

Other practice location 1

720 S Brom
S104
Naperville, IL 60540
Phone (630) 717-9977

Other practice location 2

1051 Perimeter Dr Ste 150
Schaumburg, IL 60173-5075
Phone (847) 221-4300

Other identifiers 2

IdentifierTypeStateIssuer
036110233MedicaidIL
036110233OtherILSTATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ptagamol@womancarepc.com

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036110233ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Endeavor Health Medical Group Past Accepting new patients
Advanced OB Gyne Associates Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1659404945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S BROM",
            "address_2": "S104",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "60540",
            "telephone_number": "630-717-9977",
            "fax_number": "630-717-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 W RAND RD STE 101",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600042315",
            "telephone_number": "847-221-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 S Brom",
            "address_2": "S104",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "60540",
            "country_code": "US",
            "telephone_number": "630-717-9977",
            "fax_number": "630-717-6267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1051 Perimeter Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601735075",
            "country_code": "US",
            "telephone_number": "847-221-4300",
            "fax_number": "847-221-4396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAGAMOLILA",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036110233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110233",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036110233",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptagamol@womancarepc.com",
            "affiliation": "N",
            "address_1": "1051 W Rand Rd Ste 101",
            "city": "Arlington Heights",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600042315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.