Healthcare Provider Details

I. General information

NPI: 1790311710
Provider Name (Legal Business Name): JASON K ONUGHA MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W MADISON ST STE 1000
CHICAGO IL
60661-2559
US

IV. Provider business mailing address

500 W MADISON ST STE 1000
CHICAGO IL
60661-2559
US

V. Phone/Fax

Practice location:
  • Phone: 708-942-1757
  • Fax: 312-940-4211
Mailing address:
  • Phone: 708-942-1757
  • Fax: 312-940-4211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number36.161683
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036161683
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: