PAULINA MED CLINIC NPI 1316103286

NPI Information

  • NPI: 1316103286
  • Provider Name: PAULINA MED CLINIC
  • Classification: General Practice - 208D00000X
  • Entity Type: Organization
  • CLIA Number: 14D0856173
  • Address: 3525 W PETERSON AVE
    SUITE 611
    CHICAGO, IL
    ZIP 60659
  • Phone: (773) 583-7793

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NPI Details

PAULINA MED CLINIC is a general practice in Chicago, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee PAULINA MED CLINIC NPI is 1316103286. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3525 W PETERSON AVE
SUITE 611
CHICAGO, IL
ZIP 60659-324
Phone: (773) 583-7793
Fax: (773) 583-7796

The provider's authorized official is Andrea Rentea .
The authorized official title is Doctor and has the following contact phone number (773) 583-7793.

The CLIA number assigned to this NPI record is 14D0856173 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/31/2008 and was last updated on 12/2/2011.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral Practice036058737ILLINOISYes

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
1714740MEDICARE PIN

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: 11/21/2025

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