DIVERSEY MEDICAL CENTER SC NPI 1720096969

NPI Information

NPI: 1720096969
Provider Name: DIVERSEY MEDICAL CENTER SC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
2320 W PETERSON AVENUE
CHICAGO, IL
ZIP 60659
Phone: (773) 508-9800
Get Directions

DIVERSEY MEDICAL CENTER SC is a cardiovascular disease internal medicine in Chicago, IL. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. DIVERSEY MEDICAL CENTER SC NPI is 1720096969. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2320 W PETERSON AVENUE
CHICAGO, IL
ZIP 60659-242
Phone: (773) 508-9800
Fax: (773) 508-1796

The provider's authorized official is Aref Senno .
The authorized official title is Owner and has the following contact phone number (773) 508-9800.

The enumeration date for this NPI number is 8/4/2006 and was last updated on 4/20/2008.

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	Primary
1	111N00000X	Chiropractor		No
2	207RG0100X	Internal Medicine	Gastroenterology	No
3	207W00000X	Ophthalmology		No
4	207Y00000X	Otolaryngology		No
5	208VP0014X	Pain Medicine	Interventional Pain Medicine	No
6	213E00000X	Podiatrist		No
7	225100000X	Physical Therapist		No
8	207RC0000X	Internal Medicine	Cardiovascular Disease	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	752360	MEDICARE PIN
2	=========	MEDICAID	ILLINOIS
3	01616720	OTHER		BCBS

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

NPI Synchronization or Removal

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