Henry T Pimentel MDSC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036041603 Issued in IL

Legal business name

HENRY T PIMENTEL MDSC

Practice address

326 W 64TH St
Chicago, IL 60621-3114

Phone

(773) 962-3900

NPI assigned

Jun 15, 2007

Organization subpart

No

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

Authorized official

Name

Henry T Pimental, M.D.

Title

Owner

Phone

(773) 651-9200

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1144425794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 W 79TH ST",
            "address_2": "SUITE 400",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604591784",
            "telephone_number": "773-884-4523",
            "fax_number": "773-884-4580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 W 64TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606213114",
            "telephone_number": "773-962-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENRY T PIMENTEL MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "PIMENTAL",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-651-9200",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IL",
            "license": "036041603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036041603",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "215344",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "21623403",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henry Ford Health St. John Hospital (St John Hospital and Medical Center)
• Henry G. Conroe, M.D., S.C.
• Henry Lopez Cordero, M.D., S.C.
• Henry M Baraniewski, M.D. LTD (Henry M Baraniewski, M.D.)
• Henry Spunar
• Henry Y Lin MD SC
• Lisa Michelle Henry-Reid, M.D.
• Deborah Henry-Walker, FNP-BC
• Alyson Elizabeth Henry, PH.D.
• Androni Henry, M.D.

• Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.