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Contact Information

PETHAM MUTHUSWAMY, MD
7531 SOUTH STONY ISLAND
SUITE 169
CHICAGO, IL60649
 Phone: 773-947-7715
 Fax: 773-643-0175
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Critical Care Medicine

207RC0200X 11 Physician/Internal Medicine
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for PETHAM MUTHUSWAMY · (Male)

NPI # 1205922770
Status Active
Credentials MD
Entity Individual
Enumeration date 10/04/2006
Last updated 03/07/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036047024
  • IL License # 03604724
  • IL Medicaid 036047024
  • IL Other 0002201085 BLUE CROSS BLUE SHIELD
  • IL Other 362993972 COMMERCIAL INSURANCES
  • IL Other 46K13 EMPIRE BCBS
  • IL Other 4880209 SHARE
  • IL Other 362993972 TAX ID #
  • IL Other 110017592 TRM
  • IL Other 202773 UNITED HEALTH CARE
  • TN Other 3048491 BCBS OF TN
Hospital affiliation(s)
  • JACKSON PARK HOSPITAL - (Acute Care)
    7531 S STONY ISLAND AVE
    CHICAGO, IL 60649
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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