Individual provider Active NPI

Hazel J Langcauon, M.D.

  • Family Medicine Physician
  • Coal City, IL
National Provider Identifier
1922386374
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036126883 Issued in IL
Practice address
5775 E State Route 113
Coal City, IL 60416-7111
Phone
(815) 634-0100
NPI assigned
Aug 2, 2011
Last updated
Aug 2, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 036126883 IL Primary

Addresses

Primary practice location

5775 E State Route 113
Coal City, IL 60416-7111

Mailing address

350 N Wall St
Kankakee, IL 60901-2901

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
I20120430000464 IL Practitioner - Family Practice 1658533179 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Community Health NetworkGroup PAC ID 9537076112, 182 clinicians

Practice addresses (Care Compare)

152 W Lincoln Hwy
Chicago Heights, IL 60411-2619
Phone (708) 754-9687

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036126883ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Community Health Network CurrentSince May 1, 2017 Accepting new patients
Access Community Health Network Current Accepting new patients

Locations

600 W Fulton St
Ste 200
Chicago, IL 60661
Phone (312) 526-2000

152 W Lincoln Hwy
Chicago Hts, IL 60411
Phone (708) 754-9687

Interoperability endpoints

  • Direct secure messaging: hlangcauon6817@direct.achn.net

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, 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": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1922386374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609012901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 E STATE ROUTE 113",
            "city": "COAL CITY",
            "state": "IL",
            "postal_code": "604167111",
            "telephone_number": "815-634-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGCAUON",
        "first_name": "HAZEL",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036126883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coal City, IL

Sources for this page

Verify at the official NPI Registry.