Individual provider Active NPI

Benjamin Alejandro Vazquez Jr., MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1700449824
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036161204 Issued in IL
Practice address
1740 W Taylor St
Chicago, IL 60612-7232
Phone
(866) 600-2273
NPI assigned
Apr 15, 2019
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036161204 IL Primary
Internal Medicine Physician 207R00000X 125074616 IL

Addresses

Primary practice location

1740 W Taylor St
Chicago, IL 60612-7232

Mailing address

840 S Wood St
Chicago, IL 60612-4325
Phone (866) 600-2273

Other practice location 1

5841 S Maryland Ave Ste Mc7082
Chicago, IL 60637-1465
Phone (773) 702-6840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220908003224 IL Practitioner - HospitalistPractitioner - Internal Medicine 6103151451 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

845 W Wilson Ave
Uic Medicine
Chicago, IL 60640-8090
Phone (312) 744-1295

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036161204ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince Dec 11, 2023 Accepting new patients
Rush University Medical Group Internal Medicine CurrentSince Jul 6, 2022 Accepting new patients
Rush University Medical Center CurrentSince Jul 6, 2022 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Internal Medicine CurrentSince Dec 11, 2023 Accepting new patients

Locations

1620 W Harrison St
Chicago, IL 60612
Phone (312) 942-4200

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

1740 W Taylor St
Ste 1400
Chicago, IL 60612
Phone (312) 413-3805

5841 S Maryland Ave
Ste MC7082
Chicago, IL 60637
Phone (773) 702-6840

75 Remittance Dr
Dept 1611
Chicago, IL 60675

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

7732 Solutions Ctr
Chicago, IL 60677

840 S Wood St
Chicago, IL 60612
Phone (312) 996-6043

845 W Wilson Ave
Chicago, IL 60640
Phone (312) 744-1295

Interoperability endpoints

  • Direct secure messaging: bvazquezmartinez151774@uihealth.direct-ci.com

Organizations & group practices 5

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1700449824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "866-600-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606127232",
            "telephone_number": "866-600-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave Ste Mc7082",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371465",
            "country_code": "US",
            "telephone_number": "773-702-6840",
            "fax_number": "773-702-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "BENJAMIN",
        "middle_name": "ALEJANDRO",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-15",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036161204",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125074616",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.