MR. MARIO JOSE ASTACIO (NPI# 1508073198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508073198 |
| Entity Type | Individual |
| Full Name | MR. MARIO JOSE ASTACIO |
| Credential | P.A.-C |
| Practice Address |
1140 N Mclean Blvd Suite C Elgin IL 60123-1782 |
| Mailing Address |
36w649 Winding Trl West Dundee IL 60118-9350 |
| Practice Telephone | 2245238971 |
| Practice Fax Number | 2242200840 |
| Mailing Telephone | 2245585493 |
| Mailing Fax Number | 2242200840 |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2014-01-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
085-002516 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE PROVIDER LICENCE | 085-002516 | 01 |
| Street Address |
1140 N MCLEAN BLVD SUITE C |
| City | ELGIN |
| State | IL |
| Zip Code | 60123-1782 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730236035 | Angel Gomez-galan | Internal Medicine | 1140 N Mclean Blvd, Ste E, Elgin, IL 60123-1782 | 2007-01-05 |
| 1144837204 | Winter Ashley Lane | Social Worker | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2020-09-23 |
| 1912518564 | Ana Karen Perales | Community Health Worker | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2020-08-16 |
| 1669083432 | Farrah Pece | Counselor | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2020-08-13 |
| 1649894502 | Jonpaul Michel Figueroa | Counselor | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2020-06-05 |
| 1891316345 | Sandybel Aile Hernandez | Social Worker | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2020-05-06 |
| 1881215754 | Renee R Sweeney | Community Health Worker | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2020-05-02 |
| 1780203554 | Emma Pauline Petersen | Counselor | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2020-04-13 |
| 1174158265 | Ellen Patricia Johnson | Marriage & Family Therapist | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2020-03-09 |
| 1437707262 | Laura Ramirez | Counselor | 1140 N Mclean Blvd, Elgin, IL 60123-1782 | 2019-08-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625736 | Edna Lopez | Social Worker | 1140 N. Mclean Blvd #1, Elgin, IL 60123 | 2019-08-22 |
| 1003472259 | Katelyn Lee O'connell | Counselor | 695 S. Sate Street, Elgin, IL 60123 | 2019-05-14 |
| 1598235152 | Katie Elizabeth Dwyer | Counselor | 695 S. State Street, Elgin, IL 60123 | 2018-11-27 |
| 1174002778 | James M Accetta | Counselor | 52 Surry Drive, Elgin, IL 60123 | 2018-08-14 |
| 1770086175 | Griswold Home Care | Adult Companion | 707 A Davis Road, Suite 203, Elgin, IL 60123 | 2018-03-12 |
| 1003315706 | Danielle Bryant | Nurse Practitioner | 745 Fletcher Dr Ste 101, Elgin, IL 60123 | 2018-02-08 |
| 1912421470 | Deborah Foshager | Counselor | 680 Shenandoah Trail, Elgin, IL 60123 | 2017-07-26 |
| 1760903470 | Miguel Camargo | Specialist/Technologist | 12 N Aldine St, Elgin, IL 60123 | 2017-07-03 |
| 1134658594 | David Sommer | Counselor | 1460 Umbdenstock Rd, Elgin, IL 60123 | 2017-06-08 |
| 1649719618 | Faheem Unisa Syed | Clinical Nurse Specialist | 1990 Larkin Ave., Elgin, IL 60123 | 2017-02-23 |
| Find all providers in zip 60123 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811036247 | Tyesha Dawn Marie Dent | Physician Assistant | 302 North Main, Elgin, ND 58533 | 2007-02-05 |
| 1548890775 | Meredith M Rintz | Physician Assistant | 2350 Royal Blvd Ste 300, Elgin, IL 60123-4718 | 2020-01-15 |
| 1578935896 | Jenny Brophy | Physician Assistant | 1600 N Randall Rd, Suite 400, Elgin, IL 60123-7803 | 2015-10-26 |
| 1356711584 | William Larsen | Physician Assistant | 1530 N Randall Rd Ste 210, Elgin, IL 60123-7879 | 2015-09-30 |
| 1285036103 | Daniel Newbrander | Physician Assistant | 370 Summit St, Elgin, IL 60120-3843 | 2014-09-23 |
| 1114358017 | Marcon Medical Partners Inc | Physician Assistant | 1140 N Mclean Blvd, Unit C, Elgin, IL 60123-1782 | 2013-12-03 |
| 1619305034 | Alicia Joanna Van Slee | Physician Assistant | 1710 N Randall Rd, Suite 160, Elgin, IL 60123-9400 | 2013-10-22 |
| 1730524695 | Sherrie Ann Fernandes | Physician Assistant | 1990 Larkin Ave, Suite 3, Elgin, IL 60123-5827 | 2013-05-06 |
| 1821128398 | Cynthia Applehoff | Physician Assistant | 2350 Royal Blvd, Suite 300, Elgin, IL 60123-4719 | 2007-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707298 | Eliza Ballen | Physician Assistant | 335 Sylvan Rd, Lake Bluff, IL 60044-2562 | 2020-07-21 |
| 1477177947 | Rybecca Janovyak | Physician Assistant | 14432 High Rd, Lockport, IL 60441-9402 | 2020-06-01 |
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1801429873 | Hinjal D Jha | Physician Assistant | 22285 N Pepper Rd Ste 409, Lake Barrington, IL 60010-2542 | 2020-02-19 |
| 1770120222 | Alvina Shaikh | Physician Assistant | 4009 Warren Ave, Bellwood, IL 60104-2066 | 2019-12-03 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1538705272 | Bethany Mae Frisby | Physician Assistant | 8630 W Golf Rd, Niles, IL 60714-5600 | 2019-11-18 |
| 1134761984 | Ella-marie Rakowski | Physician Assistant | 25 Acorn Dr, Hawthorn Woods, IL 60047-7407 | 2019-10-14 |
| 1467001859 | Timothy Omotayo Adesanya | Physician Assistant | Graham Correctional Center, 12078 Illinois Rte 185, Hilliboro, IL 62049 | 2019-09-09 |
| 1518514066 | Victoria Moore | Physician Assistant | 979 W Main St, West Dundee, IL 60118-2088 | 2019-08-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.