DIVERSEY MEDICAL CENTER SC; NPI #1720096969

Contact Information

DIVERSEY MEDICAL CENTER SC

2320 W PETERSON AVENUE
CHICAGO, IL 60659-5242

Phone: 773-508-9800
Fax: 773-508-1796
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Cardiovascular Disease	207RC0000X	11	Physician/Internal Medicine
Chiropractor	111N00000X	35	Chiropractic
Gastroenterology	207RG0100X	10	Physician/Gastroenterology
Interventional Pain Medicine	208VP0014X	09	Physician/Interventional Pain Management
Ophthalmology	207W00000X	18	Physician/Ophthalmology
Otolaryngology	207Y00000X	04	Physician/Otolaryngology
Physical Therapist	225100000X	65	Physical Therapist in Private Practice
Podiatrist	213E00000X	48	Podiatry

Indicates primary specialty

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NPI Profile & details for DIVERSEY MEDICAL CENTER SC

NPI Number 1720096969

LBN Legal business name DIVERSEY MEDICAL CENTER SC

Authorized official AREF SENNO - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/04/2006

Last updated 04/20/2008 - About 18 years ago

Identifiers

Other

01616720

BCBS

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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DIVERSEY MEDICAL CENTER SC

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NPI Profile & details for DIVERSEY MEDICAL CENTER SC

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