San Pablo Medical Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36083101 Issued in IL

Legal business name

SAN PABLO MEDICAL CENTER

Practice address

2641 W Division St
Chicago, IL 60622-2851

Phone

(773) 227-3500

Fax

(773) 227-0432

NPI assigned

Nov 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Amer Rustom, MD

Title

Medical Director

Phone

(773) 227-3500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1487733028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222851",
            "telephone_number": "773-227-3500",
            "fax_number": "773-227-0432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222851",
            "telephone_number": "773-227-3500",
            "fax_number": "773-227-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN PABLO MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "RUSTOM",
        "authorized_official_first_name": "AMER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-227-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36083101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ma. Olivia Roque San Diego, MD
• Aleyda Maria San Hernandez, MD
• April Lei San Juan, DNP, APN, FNP-C
• Lauren San Juan, PHARMD
• Genevieve San Nicolas, APRN, AGACNP-BC, DNP
• San Pablo Medical Center, LTD.
• Eva San Pedro-Koontz, LPC
• Brian San Pedro, PHARMD
• Ali San, DO
• Sana Connections, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.