Active NPI
Nathan Van Cao
- Student in an Organized Health Care Education/Training Program
- Chicago, IL
National Provider Identifier
1730838392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 836 West Wellington Ave
Chicago, IL 60657-6019 - Phone
- (773) 975-1600
- NPI assigned
- Mar 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary | ||
| Anesthesiology Physician | 207L00000X | 1730838392 | CA |
Addresses
Primary practice location
836 West Wellington Ave
Chicago, IL 60657-6019
Mailing address
1800 N California St
Stockton, CA 95204-6019
Phone (209) 547-5941
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 |
|---|---|---|---|
| 1730838392 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687651200000",
"number": "1730838392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952046019",
"telephone_number": "209-547-5941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "836 WEST WELLINGTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606576019",
"telephone_number": "773-975-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAO",
"first_name": "NATHAN",
"middle_name": "VAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-21",
"last_updated": "2023-06-25",
"certification_date": "2023-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "1730838392",
"primary": false
}
],
"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 Jun 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.