Peter McDonnell MD, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

036079089 Issued in IL

Legal business name

PETER MCDONNELL MD, LLC

Practice address

7530 W College Dr
Palos Heights, IL 60463-1196

Phone

(708) 923-6444

Fax

(708) 923-0705

NPI assigned

Oct 13, 2014

Organization subpart

No

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

Authorized official

Name

Peter McDonnell, MD

Title

MD

Phone

(708) 923-6444

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413158400000",
    "number": "1730583261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7530 W COLLEGE DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631196",
            "telephone_number": "708-923-6444",
            "fax_number": "708-923-0705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7530 W COLLEGE DR",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631196",
            "telephone_number": "708-923-6444",
            "fax_number": "708-923-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER MCDONNELL MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A",
        "authorized_official_last_name": "MCDONNELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "708-923-6444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036079089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1114014693",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Practice Alliance LLC
• Daniella Pedroza
• Marisa Noemi Pellegrini
• Joanna Perez, APRN, CNP
• Peter J. McDonnell M.D. SC
• Constantine G Peters, D.O.
• Bradford G Peterson, M.D.
• Mary Peterson, D.C.
• Theresa Pham, D.D.S.
• Phe Skilled Nursing Facility LLC

• Vascular Surgery Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Vascular Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.