NPIMap

Organization Active NPI

University Pathologists P C

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1003890534
Registry record updated Oct 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
UNIVERSITY PATHOLOGISTS P C
Practice address
1653 W Congress Pkwy
Chicago, IL 60612-3833
Phone
(312) 942-5700
NPI assigned
Nov 29, 2005
Last updated
Oct 31, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert Decresce, MDNPI 1114902814
Title
President
Phone
(312) 942-5254

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X NU Primary

Addresses

Primary practice location

1653 W Congress Pkwy
Chicago, IL 60612-3833

Mailing address

5700 Southwyck Blvd
Toledo, OH 43614-1509
Phone (800) 288-8325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040407000215 IL Part B Supplier - Clinic/Group Practice 6305839192 Receives reassigned benefits from 21 practitioners
Practice locations: Watseka, IL; Kankakee, IL; Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383177600000",
    "number": "1003890534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141509",
            "telephone_number": "800-288-8325",
            "fax_number": "419-866-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 W CONGRESS PKWY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123833",
            "telephone_number": "312-942-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY PATHOLOGISTS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2013-10-31",
        "status": "A",
        "authorized_official_last_name": "DECRESCE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-942-5254",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.