Active NPI
Jose L. Medina, M.D.
- Specialist
- Chicago, IL
National Provider Identifier
1679673214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 5015 N Paulina St
Suite 325
Chicago, IL 60640-2756 - Phone
- (773) 775-7540
- Fax
- (773) 763-9792
- NPI assigned
- Sep 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | IL | Primary |
Addresses
Primary practice location
5015 N Paulina St
Suite 325
Chicago, IL 60640-2756
Mailing address
5015 N Paulina St
Suite 325
Chicago, IL 60640-2756
Phone (773) 775-7540
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedish Covenant Management Services, Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Chicago, IL
- NPI 1962049551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679673214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5015 N PAULINA ST",
"address_2": "SUITE 325",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606402756",
"telephone_number": "773-775-7540",
"fax_number": "773-763-9792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5015 N PAULINA ST",
"address_2": "SUITE 325",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606402756",
"telephone_number": "773-775-7540",
"fax_number": "773-763-9792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDINA",
"first_name": "JOSE",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "IL",
"license": null,
"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 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.