Organization Active NPI

Ngu MD. Wellness LTD.

  • Addiction Medicine (Internal Medicine) Physician
  • Chicago, IL
National Provider Identifier
1942585468
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
036092049 Issued in IL
Legal business name
NGU MD. WELLNESS LTD.
Practice address
400 E Randolph St
Apt 2711
Chicago, IL 60601-7329
Phone
(708) 250-8424
NPI assigned
Oct 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Authorized official

Name
Dr. Lawrence N. Ngu, M.D.
Title
Medical Director
Phone
(708) 250-8424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RA0401X 036092049 IL Primary

Addresses

Primary practice location

400 E Randolph St
Apt 2711
Chicago, IL 60601-7329

Mailing address

400 E Randolph St
Apt 2711
Chicago, IL 60601-7329
Phone (708) 250-8424

Other identifiers 1

IdentifierTypeStateIssuer
K14846OtherILMEDICARE ID TYPE UNSPECIFIED

National Provider Directory

National Provider Directory

Locations

400 E Randolph St
Apt 2
Chicago, IL 60601

NPI Registry JSON

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

{
    "created_epoch": "1318636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1942585468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E RANDOLPH ST",
            "address_2": "APT 2711",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017329",
            "telephone_number": "708-250-8424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E RANDOLPH ST",
            "address_2": "APT 2711",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017329",
            "telephone_number": "708-250-8424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NGU MD. WELLNESS LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-15",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "NGU",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "708-250-8424",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "IL",
            "license": "036092049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "K14846",
            "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 Oct 20, 2011; 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.