Villasenor in-Home Patient Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036-111596 Issued in IL

Legal business name

VILLASENOR IN-HOME PATIENT CARE LLC

Practice address

1639 Oak Park Ave
Berwyn, IL 60402-1782

Phone

(708) 788-2801

Fax

(847) 787-5252

NPI assigned

Jan 12, 2014

Last updated

Jan 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Villasenor Jr., MDNPI 1831107135

Title

Family Practice

Phone

(708) 788-2801

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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.

• Jerry Villasenor Jr., M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1831107135
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1389484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389484800000",
    "number": "1780006619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021782",
            "telephone_number": "708-788-2801",
            "fax_number": "847-787-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 OAK PARK AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604021782",
            "telephone_number": "708-788-2801",
            "fax_number": "847-787-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLASENOR IN-HOME PATIENT CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-12",
        "last_updated": "2014-01-12",
        "status": "A",
        "authorized_official_last_name": "VILLASENOR",
        "authorized_official_first_name": "JERRY",
        "authorized_official_title_or_position": "FAMILY PRACTICE",
        "authorized_official_telephone_number": "708-788-2801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-111596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• VHS of Illinois Inc (MacNeal Hospice)
• VHS of Illinois Inc (MacNeal Hospital)
• VHS of Illinois Inc (MacNeal Hospital Center for Cancer Care)
• VHS of Illinois Inc (Berwyn Magnetic Resonance Center)
• Jose Alberto Villarreal Castellanos, MD
• Martha C. Villasenor, D.D.S.
• Elba Maritza Villavicencio, M.D.
• Olga S Vinokur, M.D.
• Visionworks Inc (Visionworks)
• Margaret Anne Vizgirda, D.D.S.

• Family Medicine Physician in Berwyn, IL
• Providers in Berwyn, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2014; 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.