Organization Active NPI

Peter D. Geldner, M.D. S.C.

  • Plastic Surgery Physician
  • Chicago, IL
National Provider Identifier
1184782872
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
36069136 Issued in IL
Legal business name
PETER D. GELDNER, M.D. S.C.
Practice address
680 N Lake Shore Drive
Suite 1325
Chicago, IL 60611
Phone
(312) 981-4440
Fax
(312) 981-4441
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Peter David Geldner, MDNPI 1497866289
Title
Owner
Phone
(312) 981-4440

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
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 36069136 IL Primary

Addresses

Primary practice location

680 N Lake Shore Drive
Suite 1325
Chicago, IL 60611

Mailing address

680 N Lake Shore Drive
Suite 1325
Chicago, IL 60611
Phone (312) 981-4440

Other names 1

  • The Geldner Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041022000666 IL Part B Supplier - Clinic/Group Practice 0244291227 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Melrose Park, IL

National Provider Directory

National Provider Directory

Locations

680 N Lake Shore Dr
Ste 1325
Chicago, IL 60611
Phone (312) 981-4440

680 N Lake Shore Dr
Ste 13
Chicago, IL 60611
Phone (312) 981-4440

Practitioners & affiliated clinicians

Practitioners 1

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1184782872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DRIVE",
            "address_2": "SUITE 1325",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-981-4440",
            "fax_number": "312-981-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DRIVE",
            "address_2": "SUITE 1325",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-981-4440",
            "fax_number": "312-981-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER D. GELDNER, M.D. S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "GELDNER",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-981-4440",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": "36069136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Geldner 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 Jun 19, 2008; 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.