Individual provider Active NPI

Peter Odonnell

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1861695819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Practice address
5841 S Maryland Ave
MC 2115
Chicago, IL 60637-1447
Phone
(773) 702-4400
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

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

Addresses

Primary practice location

5841 S Maryland Ave
MC 2115
Chicago, IL 60637-1447

Mailing address

5841 S Maryland Ave
MC 2115
Chicago, IL 60637-1447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000094 IL Practitioner - Hematology/OncologyPractitioner - Internal Medicine 5698829018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/OncologyAlso: Internal Medicine
Education
University of Chicago, Pritzker School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

355 E Grand Ave
Chicago, IL 60611-5389
Phone (888) 824-0200

47 W Polk St
Suite G1
Chicago, IL 60605-2083
Phone (888) 824-0200

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (773) 702-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
336077032ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Dec 15, 2009 Accepting new patients
The University of Chicago Medical Center CurrentSince Dec 15, 2009 Accepting new patients
University of Chicago CurrentSince Jul 1, 2009 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Interoperability endpoints

  • Direct secure messaging: podonnellmd15947@uchospital.direct-ci.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861695819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "MC 2115",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "MC 2115",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODONNELL",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.