Carlos F Pedrera MD SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036051754 Issued in IL

Legal business name

CARLOS F PEDRERA MD SC

Practice address

1431 N Western Ave Ste 502
Chicago, IL 60622-1774

Phone

(773) 278-2600

Fax

(773) 278-2424

NPI assigned

Feb 15, 2006

Organization subpart

No

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

Authorized official

Name

Carlos Frank Pedrera, MD SCNPI 1437125648

Title

President

Phone

(773) 278-2600

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carlos Frank Pedrera, MD

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1437125648
  Authorized official Same address or phone

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1255305157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 N LONGMEADOW AVE",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607123205",
            "telephone_number": "847-677-7996",
            "fax_number": "847-673-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 N WESTERN AVE STE 502",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221774",
            "telephone_number": "773-278-2600",
            "fax_number": "773-278-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS F PEDRERA MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "PEDRERA",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-278-2600",
        "authorized_official_credential": "MD SC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036051754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036051754",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meghan Carlisle, PT, DPT
• Rashionda Carlisle
• Timothy Clifford Carll, MD
• Amanda Carlo, NP
• Andrew David Carlo, MD, MPH
• Carlos F Smith DPM PC
• Carlos H Zambrano MD LLC
• Carlos Ortega MD SC (Boffa Surgical Group LLC)
• Arlene Carlos, MS
• Christine Carlos

• Family Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2011; 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.