PHYSICIANS COMMUNITY MEDICAL CENTER NPI 1568489300

NPI Information

NPI: 1568489300
Provider Name: PHYSICIANS COMMUNITY MEDICAL CENTER
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

Address:
5320 W 159TH ST
STE 400
OAK FOREST, IL
ZIP 60452
Phone: (708) 798-8112
Get Directions

PHYSICIANS COMMUNITY MEDICAL CENTER is a gastroenterology internal medicine in Oak Forest, IL. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. PHYSICIANS COMMUNITY MEDICAL CENTER NPI is 1568489300. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5320 W 159TH ST
STE 400
OAK FOREST, IL
ZIP 60452-334
Phone: (708) 798-8112
Fax: (708) 224-0365

The provider's authorized official is Gerald J Mingolelli .
The authorized official title is Medical Director and has the following contact phone number (708) 535-6369.

The enumeration date for this NPI number is 7/17/2006 and was last updated on 6/13/2013.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		042-618622	ILLINOIS	No
2	207R00000X	Internal Medicine		042-618622	ILLINOIS	No
3	207V00000X	Obstetrics & Gynecology		042-618622	ILLINOIS	No
4	208600000X	Surgery		042-618622	ILLINOIS	No
5	207RG0100X	Internal Medicine	Gastroenterology	042-618622	ILLINOIS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	212861	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS

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: 5/5/2024

NPI Synchronization or Removal

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