Active NPI
P. Degand M D SC
- Internal Medicine Physician
- Chicago, IL
National Provider Identifier
1841501608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 036055665
- 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, 2015
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Acute Care Nurse Practitioner
- Chicago, IL
- NPI 1649585191
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.