Polish American Medical Center LTD

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

36098499 Issued in IL

Legal business name

POLISH AMERICAN MEDICAL CENTER LTD

Practice address

1011 State St
Lemont, IL 60439-4768

Phone

(630) 754-0375

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bohdan Fedirko, M.D.

Title

Owner

Phone

(630) 754-0375

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073558284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 STATE ST",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604394768",
            "telephone_number": "630-754-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 STATE ST",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604394768",
            "telephone_number": "630-754-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POLISH AMERICAN MEDICAL CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FEDIRKO",
        "authorized_official_first_name": "BOHDAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-754-0375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "IL",
            "license": "36098499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor John Pfaendtner, D.O
• Taylor Pietras
• PK Chandarana MD LTD
• Pmi Services, LLC
• Lisa C Pocius, MD
• Allison Popek, RBT
• Kenneth Porter, MD
• Bethany Potempa, PMHNP
• William H Powers, PHARM.D.
• Prairie Glen Primary Care, P.C.

• Legal Medicine in Lemont, IL
• Providers in Lemont, IL by specialty
• Legal Medicine in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.