Southtown Medical Center, Llc in Chicago - General Practice
Southtown Medical Center, Llc - NPI 1629022058
Southtown Medical Center, Llc is a General Practice in Chicago, Illinois. Southtown Medical Center, Llc practices all healthcare services and medical treatments related to General Practice. The NPI Number for Southtown Medical Center, Llc is 1629022058. The last update date is 2008-05-02.
Southtown Medical Center, Llc's current location address is 6342 S Pulaski Rd, Chicago, Illinois. You can contact this provider via phone number 7732848601. The mailing address for Southtown Medical Center, Llc is 6342 S Pulaski Rd, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Southtown Medical Center, Llc |
|---|---|
| Address | 6342 S Pulaski Rd, Chicago, Illinois |
| Phone Number | 7732848601 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CEO |
|---|---|
| Authorized Official Name | Vallury A Venkata |
| Credentials | MD |
| Telephone Number | 7732848601 |
NPI Number Detail
| NPI Number | 1629022058 |
|---|---|
| Provider Enumeration Date | 2006-05-20 |
| Last Updated Date | 2008-05-02 |
Provider Mailing Address Detail
| Address | 6342 S Pulaski Rd |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606294706 |
| Phone Number | 7732848601 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 208D00000X |
|
Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36069911 | IL | -- | |
| 36101348 | IL | -- | |
| 1174528061 | IL | MEDICARE NPI | |
| 1356346241 | IL | MEDICARE NPI | |
| 1634276 | IL | BCBS |
Post Comment/ Review Below
What is the Southtown Medical Center, Llc's 1629022058?
The Southtown Medical Center, Llc's NPI (National Provider Identifier) Number is 1629022058. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Southtown Medical Center, Llc's facilities are situated?
The facilities of Southtown Medical Center, Llc are physically located at the following address: 6342 S Pulaski Rd, Chicago, IL, 606294706.
What is the Southtown Medical Center, Llc's area of specialization and corresponding taxonomy classification?
The Southtown Medical Center, Llc's specialty field is General Practice, and it falls under the taxonomy code 208D00000X, which categorizes healthcare providers based on their specialties.
On what date did Southtown Medical Center, Llc receive its 1629022058 assignment from the Centers for Medicare & Medicaid Services?
The Southtown Medical Center, Llc was assigned its 1629022058 on 2006-05-20, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Southtown Medical Center, Llc most recently updated or refreshed?
The details pertaining to the Southtown Medical Center, Llc, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-05-02.