Active NPI
Mae Pastoriza
- Contractor
- Sterling, IL
National Provider Identifier
1730464371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 056008719
- Practice address
- 612 W 23Rd St
Sterling, IL 61081-9040 - Phone
- (815) 626-9020
- NPI assigned
- Oct 14, 2011
- Last updated
- Oct 14, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 056008719 | IL | Primary |
Addresses
Primary practice location
612 W 23Rd St
Sterling, IL 61081-9040
Mailing address
7500 N Ridge Blvd Apt D
Chicago, IL 60645-1957
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056008719 | IL | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318550400000",
"number": "1730464371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7500 N RIDGE BLVD APT D",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606451957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 W 23RD ST",
"city": "STERLING",
"state": "IL",
"postal_code": "610819040",
"telephone_number": "815-626-9020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASTORIZA",
"first_name": "MAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-14",
"last_updated": "2011-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "IL",
"license": "056008719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.