Individual provider Active NPI

Jeffrey Alan Dugas Sr., MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1760566954
Registry record updated Jul 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036071610 Issued in IL
Practice address
800 S Wells St Ste M15
Chicago, IL 60607-4559
Phone
(312) 255-1580
Fax
(312) 255-0783
NPI assigned
Oct 24, 2006
Last updated
Jul 9, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2019

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 036071610 IL Primary

Addresses

Primary practice location

800 S Wells St Ste M15
Chicago, IL 60607-4559

Mailing address

800 S Wells St Ste M15
Chicago, IL 60607-4559
Phone (312) 255-1580

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
I20051114000156 IL Practitioner - Internal Medicine 8729006663

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036071610ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar-Crosse Research Center,SC Internal Medicine PastSince Apr 15, 2006 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1760566954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S WELLS ST STE M15",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074559",
            "telephone_number": "312-255-1580",
            "fax_number": "312-255-0783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S WELLS ST STE M15",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074559",
            "telephone_number": "312-255-1580",
            "fax_number": "312-255-0783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUGAS",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036071610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.