Individual provider Active NPI

Jessica Aretha Peterson, M.D.

  • Maternal & Fetal Medicine Physician
  • Chicago, IL
National Provider Identifier
1013361666
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
036163367 Issued in IL
Practice address
6250 S Cottage Grove Ave
Chicago, IL 60637-2530
Phone
(773) 702-2193
NPI assigned
Apr 20, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 036163367 IL
Student in an Organized Health Care Education/Training Program 390200000X
Maternal & Fetal Medicine Physician 207VM0101X 036163367 IL Primary

Addresses

Primary practice location

6250 S Cottage Grove Ave
Chicago, IL 60637-2530

Mailing address

1136 S Delano CT W
Chicago, IL 60605-3740
Phone (813) 610-5996

Other practice location 1

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231012002778 IL Practitioner - Obstetrics/Gynecology 0446605349 Reassigns benefits to 3 organizations
I20240501001513 IN Practitioner - Obstetrics/Gynecology 0446605349 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians
The University of Chicago Medical CenterGroup PAC ID 7618880766, 907 clinicians
Friend Family Health Center IncGroup PAC ID 2062494552, 36 clinicians

Practice addresses (Care Compare)

10855 Virginia St
Suite 1700
Crown Point, IN 46307-0210
Phone (888) 824-0200

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000

6250 S Cottage Grove Ave
Chicago, IL 60637-2530
Phone (773) 702-0660

Hospital & facility affiliations

  • The University of Chicago Medical Center Hospital, Chicago, IL, CCN 140088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036163367ILMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Oct 3, 2023 Accepting new patients
Friend Family Health Center Inc CurrentSince Sep 1, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Oct 3, 2023 Accepting new patients
Friend Family Health Center Inc Current Accepting new patients
University of Chicago CurrentSince Oct 3, 2023 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

800 E 55th St
Chicago, IL 60615
Phone (773) 702-2193

5843 S Western Ave
Chicago, IL 60636
Phone (773) 434-8600

1522 E 63rd St
Chicago, IL 60637
Phone (773) 795-2260

6250 S Cottage Grove Ave
Chicago, IL 60637
Phone (312) 682-6110

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

10855 Virginia St
Ste 1700
Crown Point, IN 46307

1500 S Lake Park Ave
Ste 109
Hobart, IN 46342
Phone (219) 942-0551

Interoperability endpoints

  • Direct secure messaging: jpeterson278389@uchospital.direct-ci.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1013361666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 S DELANO CT W",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606053740",
            "telephone_number": "813-610-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6250 S COTTAGE GROVE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606372530",
            "telephone_number": "773-702-2193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371443",
            "country_code": "US",
            "telephone_number": "773-702-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "JESSICA",
        "middle_name": "ARETHA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036163367",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VM0101X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "IL",
            "license": "036163367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.