Provider Demographics
NPI:1689005944
Name:ERNESTO J. VILLEGAS MD, SC
Entity Type:Organization
Organization Name:ERNESTO J. VILLEGAS MD, SC
Other - Org Name:ERGOMEDICA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:J
Authorized Official - Last Name:VILLEGAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-733-0909
Mailing Address - Street 1:311 N ABERDEEN ST
Mailing Address - Street 2:SUITE 100-B
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-1251
Mailing Address - Country:US
Mailing Address - Phone:312-733-0909
Mailing Address - Fax:312-733-0908
Practice Address - Street 1:311 N ABERDEEN ST
Practice Address - Street 2:SUITE 100-B
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-1251
Practice Address - Country:US
Practice Address - Phone:312-733-0909
Practice Address - Fax:312-733-0908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care