DR. PETER F MACENTEE (NPI# 1417045501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417045501 |
| Entity Type | Individual |
| Full Name | DR. PETER F MACENTEE |
| Credential | M.D. |
| Practice Address |
10627 S Pulaski Rd Chicago IL 60655-3827 |
| Practice Telephone | 7737799300 |
| Practice Fax Number | 7737795768 |
| Mailing Telephone | (773) 779-9300 |
| Mailing Fax Number | 7737795768 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | LL777 | FL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 036047977 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036047977 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2355 Stanford Ct Unit 701, Naples, FL 341124813 | 2395667425 | 2395933430 |
| Street Address |
10627 S PULASKI RD |
| City | CHICAGO |
| State | IL |
| Zip Code | 60655-3827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700974821 | Timothy E Knox | Family Medicine | 10627 S Pulaski Rd, Chicago, IL 60655-3827 | 2006-10-11 |
| 1275729303 | Macentee Knox & Vargas Mds | Preferred Provider Organization | 10627 S Pulaski Rd, Chicago, IL 60655-3827 | 2007-09-21 |
| 1467540567 | Rafael J Vargas-zapata | Family Medicine | 10627 S Pulaski Rd, Chicago, IL 60655-3827 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629632401 | Hillary Woodward Carroll | Nurse Practitioner | 3258 W 111th Chicago, Il, Chicago, IL 60655 | 2019-04-26 |
| 1679029995 | Meghan Robbins | Pharmacy Technician | 10428 S. Springfield, Chicago, IL 60655 | 2016-08-28 |
| 1356700728 | Molly Samansky | Speech-Language Pathologist | 2549 W 106thh Pl, Chicago, IL 60655 | 2016-02-15 |
| 1134533615 | Axis Physical Medicine | Physical Therapist | 11005 S Kedzie Ave, Chicago, IL 60655 | 2014-06-12 |
| 1821439738 | Mercy Circle | Skilled Nursing Facility | 3659 W. 99th Street, Chicago, IL 60655 | 2013-07-09 |
| 1962772921 | E.m. Branch and Associates, Inc | Social Worker | 3139 W. 111th Street, Chicago, IL 60655 | 2012-01-09 |
| 1922377951 | Patricia Murphy | Counselor | 10435 Kedzie Ave, Chicago, IL 60655 | 2011-12-20 |
| 1346518891 | Kelly Diana Koch | Occupational Therapist | 11143 S. Troy, Chicago, IL 60655 | 2011-12-12 |
| 1265678544 | Lawrence Michael Furlan | Dentist | 10900 S Kedzie, Chicago, IL 60655 | 2008-12-17 |
| 1710122361 | Athletico, Ltd | Physical Therapist | 3644 W. 111th Street, Chicago, IL 60655 | 2008-12-11 |
| Find all providers in zip 60655 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911495 | Moataz Barkat | Family Medicine | 3315 W 66th Pl, Chicago, IL 60629-3427 | 2020-10-26 |
| 1558976589 | Jasmine Ashley Fowler | Family Medicine | 2416 N Lotus Ave, Chicago, IL 60639-1435 | 2020-09-15 |
| 1720699176 | Healing Hands Resource Center Streator | Family Medicine | 2128 S Central Park Ave, Chicago, IL 60623-3113 | 2020-08-10 |
| 1285251892 | Soe Lwin Oo | Family Medicine | 1625 E 75th St # 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1124645700 | Timothy Alan Williams Jr. | Family Medicine | 1625 E 75th St Fl 1, Chicago, IL 60649-3603 | 2020-06-30 |
| 1194340026 | Kaysha Lynne Ribao | Family Medicine | 2116 S Springfield Ave, Chicago, IL 60623-2465 | 2020-06-16 |
| 1932724341 | Toni Kurian | Family Medicine | 1550 S Indiana Ave Apt 407, Chicago, IL 60605-4822 | 2020-06-11 |
| 1528689486 | Thurman J Robertson | Family Medicine | 1950 W. Polk Street, 7th Floor, Chicago, IL 60612-3714 | 2020-05-01 |
| 1629697297 | Lyndsey Danielle Johnson | Family Medicine | 2804 W Walton St, Chicago, IL 60622-4450 | 2020-04-13 |
| 1730708884 | Iruoma Genevieve Nwangwu | Family Medicine | 1950 W Polk Street, Chicago, IL 60612-3714 | 2020-04-09 |
| Find all providers in CHICAGO | ||||
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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.