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Contact Information

DENNIS A PEACOCK, MD
1333 W BELMONT AVE STE 100
CHICAGO, IL60657
 Phone: 312-694-2273
 Fax: 312-694-1875
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for DENNIS A PEACOCK · (Male)

NPI Number 1023223021
Status Active
Credentials MD
Entity Individual
Enumeration date 05/11/2007
Last updated 06/30/2018 - More than a year ago
Sole proprietor 1 No
Identifiers
  • IL License # 036.141382
  • LA License # 200700
  • LA Medicaid 1073849
  • MS Medicaid 05024018
Hospital affiliation(s)
  • NORTHWESTERN MEMORIAL HOSPITAL - (Acute Care)
    251 E HURON ST
    CHICAGO, IL 60611
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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