Active NPI
Maria Serratto-Benvenuto, MD
- Pediatric Cardiology Physician
- Chicago, IL
National Provider Identifier
1689685612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- 036038878
- Practice address
- 1801 W Taylor St
Suite 2E
Chicago, IL 60612-4795 - Phone
- (312) 996-7416
- Fax
- (312) 413-8778
- NPI assigned
- Aug 11, 2006
- Last updated
- Oct 17, 2013
- 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 |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | 036038878 | IL | Primary |
Addresses
Primary practice location
1801 W Taylor St
Suite 2E
Chicago, IL 60612-4795
Mailing address
840 S Wood St
M/C 856
Chicago, IL 60612-4325
Phone (312) 996-6606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036038878 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 036038878 | IL | MD | Pediatric Cardiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381968000000",
"number": "1689685612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 S WOOD ST",
"address_2": "M/C 856",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124325",
"telephone_number": "312-996-6606",
"fax_number": "312-413-3373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W TAYLOR ST",
"address_2": "SUITE 2E",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124795",
"telephone_number": "312-996-7416",
"fax_number": "312-413-8778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERRATTO-BENVENUTO",
"first_name": "MARIA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2013-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "IL",
"license": "036038878",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036038878",
"state": "IL"
}
],
"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 Oct 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.