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P D MEDICAL S.C. NPI 1124129697


NPI Information

NPI: 1124129697
Provider Name: P D MEDICAL, S.C.

Doing Business As: P & D MEDICAL, S.C.

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D0419820

Address:
4201 W 95TH ST
OAK LAWN, IL
ZIP 60453
Phone: (708) 636-1466
Get Directions

P D MEDICAL, S.C. is a family medicine in Oak Lawn, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. P D MEDICAL, S.C. NPI is 1124129697. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As P & D Medical, S.c..

The provider's business location address is:

4201 W 95TH ST
OAK LAWN, IL
ZIP 60453-615
Phone: (708) 636-1466
Fax: (708) 636-0264

The provider's authorized official is Peter B. Dragisic .
The authorized official title is Co-owner and has the following contact phone number (708) 636-1466.

The CLIA number assigned to this NPI record is 14D0419820 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/26/2006 and was last updated on 5/29/2008.


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 License Number License State Primary
1207Q00000XFamily Medicine036092116ILLINOISYes

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
101636324OTHERILLINOISBCBS
2DG6568OTHERILLINOISRAILROAD MEDICARE
3016092116MEDICAIDILLINOIS
4214948MEDICARE OSCAR/CERTIFICATIONILLINOIS

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

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