NPIMap

Organization Active NPI

Jay M Pensler,MD,SC

  • Plastic and Reconstructive Surgery Physician
  • Chicago, IL
National Provider Identifier
1235330325
Registry record updated Feb 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
Legal business name
JAY M PENSLER,MD,SC
Practice address
680 N Lake Shore Dr
Suite 1125
Chicago, IL 60611-4546
Phone
(312) 642-7777
Fax
(312) 642-3333
NPI assigned
May 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2008

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

Authorized official

Name
Dr. Jay Michael Pensler, M.D.
Title
President
Phone
(312) 642-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X IL Primary

Addresses

Primary practice location

680 N Lake Shore Dr
Suite 1125
Chicago, IL 60611-4546

Mailing address

680 N Lake Shore Dr
Suite 1125
Chicago, IL 60611-4546
Phone (312) 642-7777

National Provider Directory

National Provider Directory

Locations

680 N Lake Shore Dr
Ste 1125
Chicago, IL 60611
Phone (312) 642-7777

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201824000000",
    "number": "1235330325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1125",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-642-7777",
            "fax_number": "312-642-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 N LAKE SHORE DR",
            "address_2": "SUITE 1125",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606114546",
            "telephone_number": "312-642-7777",
            "fax_number": "312-642-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAY M PENSLER,MD,SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2008-02-01",
        "status": "A",
        "authorized_official_last_name": "PENSLER",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-642-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 1, 2008; 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.