Organization Active NPI

P. Degand M D SC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1841501608
Registry record updated Apr 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036055665 Issued in IL
Legal business name
P. DEGAND M D SC
Practice address
2555 S Martin Luther King Dr
Chicago, IL 60616-2419
Phone
(312) 842-3971
Fax
(312) 842-3691
NPI assigned
Jun 27, 2010
Last updated
Apr 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2015

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

Authorized official

Name
Dr. Pancho Degand, M.D.
Title
President
Phone
(312) 842-3971

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036055665 IL Primary

Addresses

Primary practice location

2555 S Martin Luther King Dr
Chicago, IL 60616-2419

Mailing address

2555 S Martin Luther King Dr
Chicago, IL 60616-2419
Phone (312) 842-3971

National Provider Directory

National Provider Directory

Locations

2555 S King Dr
#D
Chicago, IL 60616

2600 S Michigan Ave
Ste 310
Chicago, IL 60616
Phone (312) 791-9647

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1277596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429142400000",
    "number": "1841501608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 S MARTIN LUTHER KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162419",
            "telephone_number": "312-842-3971",
            "fax_number": "312-842-3691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 S MARTIN LUTHER KING DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606162419",
            "telephone_number": "312-842-3971",
            "fax_number": "312-842-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P. DEGAND M D SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-27",
        "last_updated": "2015-04-16",
        "status": "A",
        "authorized_official_last_name": "DEGAND",
        "authorized_official_first_name": "PANCHO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-842-3971",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036055665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2015; 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.