Broadway Medical Center

Organization Active NPI Family Medicine Physician · Melrose Park, IL

NPI 1760429609 · NPPES record last updated Sep 8, 2025

Key facts

NPI
1760429609
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
BROADWAY MEDICAL CENTER
Practice address
153 1/2 N Broadway Ave
Melrose Park, IL 60160-3702
Phone
(708) 345-8960
Fax
(708) 345-8965
NPI assigned
May 31, 2006
Organization subpart
No

Authorized official

Name
Peyman Pahlavan, M.D.
Title
President
Phone
(312) 371-9325

Practitioners 17

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20060828000090 IL Part B Supplier - Clinic/Group Practice 5395749733 Receives reassigned benefits from 14 practitioners
Practice locations: Melrose Park, IL

National Provider Directory

Locations

153 1/2 Broadway St
Melrose Park, IL 60160

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Clinic/Center 261Q00000X
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

153 1/2 N Broadway Ave
Melrose Park, IL 60160-3702

Mailing address

153 1/2 Broadway St
Melrose Park, IL 60160-3702
Phone (708) 345-8960

Other providers in Melrose Park, IL

All providers in Melrose Park, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.