NPIMap

Organization Active NPI

St Anthony Emergency Services Physician Group

  • Emergency Medical Services (Emergency Medicine) Physician
  • Chicago, IL
National Provider Identifier
1760587703
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
Legal business name
ST ANTHONY EMERGENCY SERVICES PHYSICIAN GROUP
Doing business as
St Anthony Emergency Services Physician Group
Practice address
2875 W 19TH St
Chicago, IL 60623-3501
Phone
(773) 484-4783
NPI assigned
Sep 14, 2006
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SAINT ANTHONY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Guy A Medaglia
Title
President/Ceo, Authorized Official
Phone
(773) 484-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207PE0004X Primary

Addresses

Primary practice location

2875 W 19TH St
Chicago, IL 60623-3501

Mailing address

2001 S California Ave
Chicago, IL 60608-2486
Phone (773) 484-4783

Other names 1

  • St Anthony Emergency Services Physician Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041001000476 IL Part B Supplier - Clinic/Group Practice 5698744076 Receives reassigned benefits from 33 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory
Part of
Cath HLTH Prtnr Med Dba

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

3504 W 95th St
Evergreen Pk, IL 60805

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1760587703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082486",
            "telephone_number": "773-484-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 W 19TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233501",
            "telephone_number": "773-484-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY EMERGENCY SERVICES PHYSICIAN GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT ANTHONY HOSPITAL",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "MEDAGLIA",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/CEO, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "773-484-1000"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Anthony Emergency Services Physician Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Anthony Emergency Services Physician Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.