Physicians Community Medical Center

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

042-618622 Issued in IL

Legal business name

PHYSICIANS COMMUNITY MEDICAL CENTER

Practice address

5320 W 159TH St
Ste 400
Oak Forest, IL 60452-3334

Phone

(708) 798-8112

Fax

(708) 224-0365

NPI assigned

Jul 17, 2006

Last updated

Jun 13, 2013By the provider in NPPES

Organization subpart

Yes

Parent organization

PHYSICIANS COOPERATIVEAs reported in NPPES

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

Authorized official

Name

Dr. Gerald J Mingolelli I, M.D.NPI 1508863531

Title

Medical Director

Phone

(708) 535-6369

Specialties & licenses 5

Addresses

Part of

Physicians Community Medical Center

Locations

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.

• Gerald J Mingolelli, MD

  • Gastroenterology Physician
  • Hazel Crest, IL
  • NPI 1508863531
  Authorized official Same address or phone

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1568489300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 W 159TH ST",
            "address_2": "STE 400",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523334",
            "telephone_number": "708-798-8112",
            "fax_number": "708-224-0365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W 159TH ST",
            "address_2": "STE 400",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604523334",
            "telephone_number": "708-798-8112",
            "fax_number": "708-224-0365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS COMMUNITY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHYSICIANS COOPERATIVE",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "MINGOLELLI",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "708-535-6369",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "042-618622",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "042-618622",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "042-618622",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "042-618622",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "042-618622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Esther Patch, M.D.
• Usha Patel, R.N.
• PCMC East
• Perpetual Home Health, Inc.
• Sherry Ann Petro, L.C.S.W.
• Physicians Community Medical Center North, S.C.
• Physicians Community Medical Center Oak Forest, S.C.
• Physicians Community Medical Specialists
• Physicians Community Pharmacy, Inc
• Jenna C Podjasek, MD

• Gastroenterology Physician in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.