Provider Demographics
NPI:1750379889
Name:FIGUEROA, JOSE GERARDO (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:GERARDO
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 EAST CARPENTER STREET
Mailing Address - Street 2:ROOM 2K64
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62769-0001
Mailing Address - Country:US
Mailing Address - Phone:217-525-5643
Mailing Address - Fax:217-544-3311
Practice Address - Street 1:16528 S WOODSTONE DR
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-9509
Practice Address - Country:US
Practice Address - Phone:217-717-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036070640207L00000X
MO2017040127207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036070640Medicaid
MO204388102Medicaid
ILL96592Medicare ID - Type UnspecifiedMEDICARE PART B
IL104409OtherHEALTHLINK GROUP NUMBER
IL779520Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
IL8415040OtherBLUE CROSS NUMBER
ILCF2131Medicare ID - Type UnspecifiedMEDICARE RR GROUP NUMBER
ILL96592Medicare ID - Type UnspecifiedMEDICARE PART B
IL32490OtherPERSONAL CARE
IL454609OtherHEALTHLINK UPIN NUMBER