Petrovas Medical Center, S.C

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

042007949 Issued in IL

Legal business name

PETROVAS MEDICAL CENTER, S.C

Practice address

5962 N Lincoln Ave Ste 12
Chicago, IL 60659-3762

Phone

(773) 989-0585

NPI assigned

May 15, 2008

Organization subpart

No

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

Authorized official

Name

Demtrios Petrovas

Title

President

Phone

(773) 989-0585

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Demetrios Petrovas, MD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1871547505
  Medicare reassignment

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1689841801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5962 N LINCOLN AVE STE 12",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5962 N LINCOLN AVE STE 12",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606593762",
            "telephone_number": "773-989-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETROVAS MEDICAL CENTER, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "PETROVAS",
        "authorized_official_first_name": "DEMTRIOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-989-0585"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "042007949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter A Petropulos, MD
• Paula Petrosino
• Morgan Petrosius
• Edgar Petrosyan, MD
• Oleg Petrov, D.P.M.
• Demetrios Petrovas, MD
• Peter S Petrovas, DC
• Bojan D Petrovic, MD
• Ivan Petrovic
• Polina V Petrovic, MD

• Medical Specialty Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.