Individual provider Active NPI

Louis Emmett De la Garza, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1740448323
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
125051354 Issued in IL
Practice address
2929 S Ellis Ave
Chicago, IL 60616-3395
Phone
(312) 791-2670
Fax
(312) 791-8006
NPI assigned
May 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125051354 IL Primary

Addresses

Primary practice location

2929 S Ellis Ave
Chicago, IL 60616-3395

Mailing address

2929 S Ellis Ave
Chicago, IL 60616-3395
Phone (312) 791-2670

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090714000422 IL Practitioner - HospitalistPractitioner - Internal Medicine 6002968575 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola Medical Group LLCGroup PAC ID 6305109547, 124 clinicians

Practice addresses (Care Compare)

3231 Euclid Ave
Suite 202
Berwyn, IL 60402-3472
Phone (708) 783-2700

Hospital & facility affiliations

  • Macneal Hospital Hospital, Berwyn, IL, CCN 140054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125051354ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jun 7, 2024 Accepting new patients
Loyola Medical Group LLC CurrentSince Mar 1, 2018 Accepting new patients
Loyola University Medical Center CurrentSince Jun 7, 2024 Accepting new patients

Locations

3249 Oak Park Ave
Fl 4
Berwyn, IL 60402
Phone (708) 783-7850

3231 Euclid Ave
Ste 202
Berwyn, IL 60402
Phone (708) 783-2700

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

3722 Harlem Ave
Ste 101
Riverside, IL 60546
Phone (708) 783-6500

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Organizations & group practices 3

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.

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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1740448323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2929 S ELLIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163395",
            "telephone_number": "312-791-2670",
            "fax_number": "312-791-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 S ELLIS AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163395",
            "telephone_number": "312-791-2670",
            "fax_number": "312-791-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA GARZA",
        "first_name": "LOUIS",
        "middle_name": "EMMETT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125051354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.