Organization Active NPI

Albert Pecherek SC.

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1144493255
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ALBERT PECHEREK SC.
Doing business as
Milwaukee Ave. Medical Center
Practice address
6438 N. Milwaukee Ave.
Chicago, IL 60631
Phone
(773) 763-9305
Fax
(773) 763-9368
NPI assigned
Apr 9, 2008
Organization subpart
Yes
Parent organization
ALBERT PECHEREK SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Dr. Albert Pecherek, M.D.NPI 1922147024
Title
President
Phone
(773) 763-9305

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IL Primary

Addresses

Primary practice location

6438 N. Milwaukee Ave.
Chicago, IL 60631

Mailing address

6438 N Milwaukee Ave
Chicago, IL 60631-2046
Phone (773) 763-9305

Other names 1

  • Milwaukee Ave. Medical Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080605000465 IL Part B Supplier - Clinic/Group Practice 6901976794 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1000101Milwaukee Ave Medical Center6438 N Milwaukee Avenue, Chicago, IL 60631Provider-performed microscopyJun 3, 2028

National Provider Directory

National Provider Directory
Part of
Albert Pecherek SC

Locations

6438 N Milwaukee Ave
Chicago, IL 60631
Phone (773) 763-9305

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1144493255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6438 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606312046",
            "telephone_number": "773-763-9305",
            "fax_number": "773-763-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6438 N. MILWAUKEE AVE.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60631",
            "telephone_number": "773-763-9305",
            "fax_number": "773-763-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERT PECHEREK SC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALBERT PECHEREK SC",
        "enumeration_date": "2008-04-09",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "PECHEREK",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-763-9305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Milwaukee Ave. Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.