Individual provider Active NPI

Maria Luna Munoz

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1861598351
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036045556 Issued in IL
Practice address
2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone
(773) 665-3045
NPI assigned
Sep 15, 2006
Last updated
Mar 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036045556 IL Primary

Addresses

Primary practice location

2900 N Lake Shore Dr
Chicago, IL 60657-5640

Mailing address

PO Box 2486
Indianapolis, IN 46206-2486

Other identifiers 5

IdentifierTypeStateIssuer
036045556MedicaidIL
364125320002OtherCHAMPUS
01621061OtherILBCBS IL
132302200OtherDEPARTMENT OF LABOR
220021538OtherRAILROAD MEDICARE

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

State licenses

LicenseStateTypeSpecialty
036045556ILMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pathology CHP, SC Anatomic Pathology & Clinical Pathology 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269302400000",
    "number": "1861598351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2486",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462062486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNOZ",
        "first_name": "MARIA",
        "middle_name": "LUNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2010-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036045556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036045556",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "364125320002",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "01621061",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "132302200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "220021538",
            "state": null
        }
    ],
    "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 23, 2010; 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.