PETERSON MEDICAL SURGICENTER (NPI# 1609955475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609955475 |
| Entity Type | Organization |
| Organization Name | PETERSON MEDICAL SURGICENTER |
| Practice Address |
2300 W Peterson Ave Chicago IL 60659-5203 |
| Mailing Address |
2320 W Peterson Ave Chicago IL 60659-5242 |
| Practice Telephone | 7735089800 |
| Practice Fax Number | 7735081796 |
| Mailing Telephone | 7735089800 |
| Mailing Fax Number | 7735081796 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GARY L. CALLAHAN (CEO) |
| Authorized Official Telephone | 7735089800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
IL | Ambulatory Health Care Facilities |
| Street Address |
2300 W PETERSON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60659-5203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437578168 | Osama Tagiuri | Specialist/Technologist, Other | 2300 W Peterson Ave, Chicago, IL 60659-5203 | 2014-04-09 |
| 1376986547 | Muhanned Ghirri | Specialist/Technologist, Other | 2300 W Peterson Ave, Chicago, IL 60659-5203 | 2013-04-08 |
| 1770769390 | Advanced Diagnostics Professional Services, Sc | Radiology | 2300 W Peterson Ave, Chicago, IL 60659-5203 | 2008-01-14 |
| 1407055288 | Celso D Delmundo | Internal Medicine | 2300 W Peterson Ave, Chicago, IL 60659-5203 | 2007-07-12 |
| 1588785380 | Peterson Occupational Health Services, Sc | Clinic/Center | 2300 W Peterson Ave, Chicago, IL 60659-5203 | 2007-04-02 |
| 1609905637 | Peterson Surgicenter Anesthesia Services Sc | Clinic/Center | 2300 W Peterson Ave, Chicago, IL 60659-5203 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811425 | Devon Homecare Physicians Inc. | Family Medicine | 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 | 2020-11-03 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1508410069 | Kara Lyn Anderson | Counselor | 2551 W. Peterson Ave, Chicago, IL 60659 | 2019-08-01 |
| 1568980019 | Saba Suleman | Counselor | 5815 N Spaulding Ave Apt 3a, Chicago, IL 60659 | 2017-09-05 |
| 1639695257 | Go Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5862 N Lincoln Ave, Suite 4, Chicago, IL 60659 | 2017-08-15 |
| 1972039568 | Trilogy, Inc. | Community/Behavioral Health | 2551 W Peterson Ave, Chicago, IL 60659 | 2017-05-03 |
| 1689029050 | Soulu | Voluntary or Charitable | 3557 W Peterson Ave #122, Chicago, IL 60659 | 2016-05-04 |
| 1730540550 | Michael Wei-tsi Chien | Dentist | 3425 W Peterson Ave Ste 107, Chicago, IL 60659 | 2016-03-08 |
| 1497129688 | Acquaint Homecare LLC | Home Health | 3525 West Peterson Avenue, Unit 118, Chicago, IL 60659 | 2015-11-25 |
| 1083054621 | Rebecca Schnell | Speech-Language Pathologist | 6124 N Saint Louis Ave, Chicago, IL 60659 | 2013-06-27 |
| Find all providers in zip 60659 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487115804 | Ontario Street Operatory Fac | Clinic/Center | 22 W Ontario Street Operatory, Chicago, IL 60654 | 2019-03-28 |
| 1477017333 | Ontario Street Operatory | Clinic/Center | 22 W Ontario St, Chicago, IL 60654-5169 | 2019-01-24 |
| 1407329501 | Chicago Cosmetic Surgery Institute | Clinic/Center | 2335 S Michigan Ave, Chicago, IL 60616-2104 | 2019-01-10 |
| 1720505787 | Midwest Ambulatory Care LLC | Clinic/Center | 1212 N La Salle Dr Ste 100, Chicago, IL 60610-2379 | 2017-08-29 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1033652557 | Windy City Surgical Services, LLC | Clinic/Center | 4740 N Cumberland Ave, Chicago, IL 60656-4239 | 2016-12-01 |
| 1548697147 | International Medical and Surgical Institute,sc | Clinic/Center | 2359 N Calfornia Ave, Chicago, IL 60647-2939 | 2013-09-27 |
| 1073813721 | Chicago Foot and Ankle Surgicare, PC | Clinic/Center | 3153 W 111th St, Chicago, IL 60655-2205 | 2010-10-28 |
| 1801106851 | Midwest Medix Surgery Center | Clinic/Center | 8630 S Pulaski Rd, Chicago, IL 60652-3633 | 2010-10-08 |
| 1245466192 | Anti Aging Surgical Center | Clinic/Center | 3918 W 63rd St, Chicago, IL 60629-4604 | 2009-06-05 |
| 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.