PETERSON MEDICAL SURGICENTER – NPI #1609955475
Clinic/Center

PETERSON MEDICAL SURGICENTER is an AHC clinic located in CHICAGO, IL. NPPES has assigned the NPI number 1609955475 to PETERSON MEDICAL SURGICENTER on November 03, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 6 years ago on Aug 22, 2020. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PETERSON MEDICAL SURGICENTER below.

NPI Profile for
PETERSON MEDICAL SURGICENTER

NPI Number
1609955475
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
PETERSON MEDICAL SURGICENTER
Primary location
2300 W PETERSON AVE
CHICAGO, IL 60659-5203
Phone: (773) 508-9800 Fax: (773) 508-1796
Mailing address
2320 W PETERSON AVE
CHICAGO, IL 60659-5242
Phone: (773) 508-9800 Fax: (773) 508-1796
Organization Subpart
No
Authorized Official
GARY CALLAHAN
CEO
Phone: (773) 508-9800
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)		 IL

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.