Active NPI
Ngu MD. Wellness LTD.
- Addiction Medicine (Internal Medicine) Physician
- Chicago, IL
National Provider Identifier
1942585468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Internal Medicine) Physician
- License
- 036092049
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Internal Medicine) Physician | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K14846 | Other | IL | MEDICARE ID TYPE UNSPECIFIED |
National Provider Directory
National Provider DirectoryLocations
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.