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:
Map and Directions
Authorized official contact:
Name: Mayuga, Ruperto Doctor of Medicine (MD)
Phone: (773) 281-7660

Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
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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