Organization Active NPI

Rodrigo F. Endara, MD PC

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1811234347
Registry record updated Jan 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036062981 Issued in IL
Legal business name
RODRIGO F. ENDARA, MD PC
Practice address
1417 N Ashland Ave
Chicago, IL 60622-2224
Phone
(773) 342-1090
Fax
(773) 342-5249
NPI assigned
Jan 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2013

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

Authorized official

Name
Mr. Rodrigo Endara, MD
Title
MD
Phone
(773) 342-1090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 036062981 IL Primary

Addresses

Primary practice location

1417 N Ashland Ave
Chicago, IL 60622-2224

Mailing address

1417 N Ashland Ave
Chicago, IL 60622-2224
Phone (773) 342-1090

Other identifiers 1

IdentifierTypeStateIssuer
036062981MedicaidIL

National Provider Directory

National Provider Directory

Locations

1417 N Ashland Ave
Chicago, IL 60622
Phone (312) 342-1090

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357344000000",
    "number": "1811234347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222224",
            "telephone_number": "773-342-1090",
            "fax_number": "773-342-5249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222224",
            "telephone_number": "773-342-1090",
            "fax_number": "773-342-5249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODRIGO F. ENDARA, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-05",
        "status": "A",
        "authorized_official_last_name": "ENDARA",
        "authorized_official_first_name": "RODRIGO",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "773-342-1090",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036062981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062981",
            "state": "IL"
        }
    ],
    "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 Jan 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.