Mayuga Medical Practice
LBN: Mayuga Medical Practice
Mayuga Medical Practice is an health care organization with primary practice located at 2800 N Sheridan Rd Suite303, Chicago IL 60657-6156. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as the primary health care specialty.
Mayuga Medical Practice can be contacted via phone (773) 281-7660, or through Mayuga, Ruperto via phone (773) 281-7660.
Contact Information
Primary practice address
2800 N Sheridan Rd Suite303
Chicago IL 60657-6156
Phone: (773) 281-7660
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 036075687 | Illinois |
Profile Details
NPI number | 1396789053 |
---|---|
LBN Legal business name | Mayuga Medical Practice |
DBA Doing business as | |
Authorized official | Mayuga, Ruperto Doctor of Medicine (MD) |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Jun 15th, 2006 |
Last updated | Mar 25th, 2014 - about 10 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1396789053 | NPPES |
Illinois | Other | 01605124 | BLUE CROSS BLUE SHIELD IL |
Illinois | MEDICAID | 036075687 | BLUE CROSS BLUE SHIELD IL |
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