Individual provider Active NPI

Manuel Antonio Villegas Roberson, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1861142010
Registry record updated Jul 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036.172462 Issued in IL
Practice address
3134 N Clark St
Chicago, IL 60657-4414
Phone
(312) 766-4949
Fax
(312) 766-4925
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 036.172462 IL Primary

Addresses

Primary practice location

3134 N Clark St
Chicago, IL 60657-4414

Mailing address

3134 N Clark St
Chicago, IL 60657-4414
Phone (312) 766-4949

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
I20251201002825 IL Practitioner - Internal Medicine 2668965476 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2800 W 95TH St
Evergreen, IL 60805-2701
Phone (708) 422-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.172462ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cimpar, S.C. Internal Medicine CurrentSince Nov 1, 2025 Accepting new patients

Locations

101 Madison St
Ste 300
Oak Park, IL 60302
Phone (773) 849-9406

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1861142010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3134 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574414",
            "telephone_number": "312-766-4949",
            "fax_number": "312-766-4925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574414",
            "telephone_number": "312-766-4949",
            "fax_number": "312-766-4925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLEGAS ROBERSON",
        "first_name": "MANUEL",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2025-07-02",
        "certification_date": "2025-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036.172462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.