Pimentel-Sychay Medical Service Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036066233 Issued in IL

Legal business name

PIMENTEL-SYCHAY MEDICAL SERVICE CORPORATION

Practice address

6032 S Halsted St # 102
Chicago, IL 60621-2112

Phone

(773) 651-9200

NPI assigned

Jun 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Sonia P Sychay, MD

Title

President

Phone

(773) 651-9200

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1326209818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6628 SHEFFIELD LN",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605275427",
            "telephone_number": "773-651-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6032 S HALSTED ST # 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212112",
            "telephone_number": "773-651-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIMENTEL-SYCHAY MEDICAL SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-18",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "SYCHAY",
        "authorized_official_first_name": "SONIA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-651-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036066233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01626031",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036066233",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Chicago, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; 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.