Active NPI
Marcelo Rocha de Sousa Cruz, M.D.
- Medical Oncology Physician
- Chicago, IL
National Provider Identifier
1831647205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Oncology Physician
- License
- 125069681
- Practice address
- 233 East Superior Street
1St Floor
Chicago, IL 60611 - Phone
- (312) 472-1234
- Fax
- (312) 472-0574
- NPI assigned
- Sep 14, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Medical Oncology Physician | 207RX0202X | 125069681 | IL | Primary |
Addresses
Primary practice location
233 East Superior Street
1St Floor
Chicago, IL 60611
Mailing address
233 East Superior Street, Suite 01-023
Chicago, IL 60611
Phone (312) 472-1234
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831647205 | Other | IL | NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125069681 | IL | MD | Medical Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Dupage Physician Group | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Carol Stream, IL
- NPI 1033149844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490572800000",
"number": "1831647205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 EAST SUPERIOR STREET, SUITE 01-023",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-472-1234",
"fax_number": "312-472-0564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 EAST SUPERIOR STREET",
"address_2": "1ST FLOOR",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60611",
"telephone_number": "312-472-1234",
"fax_number": "312-472-0574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "MARCELO",
"middle_name": "ROCHA DE SOUSA",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-14",
"last_updated": "2017-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RX0202X",
"taxonomy_group": "",
"desc": "Internal Medicine, Medical Oncology",
"state": "IL",
"license": "125069681",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1831647205",
"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 Mar 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.