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MACENTEE KNOX & VARGAS MDS NPI 1275729303


NPI Information

NPI: 1275729303
Provider Name: MACENTEE KNOX & VARGAS MDS

Doing Business As: SOUTHCARE FAMILY PRACTICE

Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
10627 S PULASKI RD
CHICAGO, IL
ZIP 60655
Phone: (773) 779-9300
Get Directions

MACENTEE KNOX & VARGAS MDS is a preferred provider organization in Chicago, IL. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. MACENTEE KNOX & VARGAS MDS NPI is 1275729303. The provider is registered as an organization entity type.
The provider Is Doing Business As Southcare Family Practice.

The provider's business location address is:

10627 S PULASKI RD
CHICAGO, IL
ZIP 60655-827
Phone: (773) 779-9300
Fax: (773) 779-5768

The provider's authorized official is Peter F Macentee .
The authorized official title is President and has the following contact phone number (773) 779-9300.

The enumeration date for this NPI number is 9/21/2007 and was last updated on 3/8/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305R00000XPreferred Provider Organization036047977ILLINOISNo
2305S00000XPoint of Service036063080ILLINOISNo
3305R00000XPreferred Provider Organization036072512ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1750290MEDICARE PINILLINOIS
2P09567MEDICARE PINILLINOIS
3L77296MEDICARE PINILLINOIS
4P09566MEDICARE PINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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