Ivan Pacold, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

36059612 Issued in IL

Practice address

2160 S 1St Ave
(1950 S. Harlem Ave., North Riverside, Il. 60546)
Maywood, IL 60153

Phone

(708) 354-9250

Fax

(708) 354-8765

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Loyola University Physician Foundation

  • General Practice Physician
  • Maywood, IL
  • NPI 1235148891
  NPD (past)
• VHS of Illinois Inc

  • Family Medicine Physician
  • Berwyn, IL
  • NPI 1124006705
  NPD (past)

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267660800000",
    "number": "1992784094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "(1950 S. HARLEM AVE., NORTH RIVERSIDE, IL. 60546)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-354-9250",
            "fax_number": "708-354-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "address_2": "(1950 S. HARLEM AVE., NORTH RIVERSIDE, IL. 60546)",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "60153",
            "telephone_number": "708-354-9250",
            "fax_number": "708-354-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACOLD",
        "first_name": "IVAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2010-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "36059612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36059612",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Rose Owczarzak, MD
• Gregory Jerard Ozark, MD
• Laura B Ozark, MD
• Timothy Ozga, MD
• Shahaad Pace
• Heather N Paddock, M.D.
• Elizabeth Anne Paganessi, MD
• Austin W Page, DO
• Angeline Fu-Hsiuan Pai, M.D.
• Wonbeom Paik, MD, PHD

• Cardiovascular Disease Physician in Maywood, IL
• Providers in Maywood, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.