Healthcare Provider Details

I. General information

NPI: 1942122130
Provider Name (Legal Business Name): PACHECO OPTIMUM HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5851 W IRVING PARK RD
CHICAGO IL
60634-2609
US

IV. Provider business mailing address

5851 W IRVING PARK RD
CHICAGO IL
60634-2609
US

V. Phone/Fax

Practice location:
  • Phone: 312-560-5585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. SONNET PACHECO
Title or Position: OWNER
Credential: RDMS
Phone: 312-560-5585