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NPI Code Detail

MEDICARE: DR. PETER A CALABRESE D.O.

MEDICARE: DR. PETER A CALABRESE D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036075915IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080117917OTHERRAILROAD MEDICARE

General Provider Information

NPI Number : 1891766275
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER A CALABRESE D.O.
Provider Business Mailing Address
First Line : 7400 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-3418
Country : US
Telephone Number : 773-625-1900
Fax Number : 773-625-5348
Provider Business Practice Location Address
First Line : 7400 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60634-3418
Country : US
Telephone Number : 773-625-1900
Fax Number : 773-625-5348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 11/26/2007

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Directions to “ DR. PETER A CALABRESE D.O.” Practice Location

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