Crestwood Medical Associates LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CRESTWOOD MEDICAL ASSOCIATES LTD

Practice address

13117 Rivercrest Dr
Crestwood, IL 60418-4419

Phone

(708) 371-1190

Fax

(708) 448-8812

NPI assigned

Jun 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Antonio Noriega, MDNPI 1073701850

Title

President

Phone

(708) 371-1190

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Antonio Noriega, MD

  • Family Medicine Physician
  • Crestwood, IL
  • NPI 1073701850
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1992746309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13117 RIVERCREST DR",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604184419",
            "telephone_number": "708-371-1190",
            "fax_number": "708-448-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13117 RIVERCREST DR",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604184419",
            "telephone_number": "708-371-1190",
            "fax_number": "708-448-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD MEDICAL ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "NORIEGA",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-371-1190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036049076",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crestwood Associated Medical Center LTD
• Crestwood Care Centre LP
• Crestwood Chiropractic and Rehab
• Crestwood Dental and TMJ Care PC
• Crestwood Dental Care PC
• Crestwood Rehabilitation Center LLC
• Crestwood Terrace Operator LLC
• CT Care, LLC
• Diana Daley, COTA
• Daniel J. Sweeney DC, LTD.

• Family Medicine Physician in Crestwood, IL
• Providers in Crestwood, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.