Physician Compare National (NPI:1144606385)

HEALTHCARE PROVIDER: SERENA PESCH

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1144606385
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1456651009
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151203001547
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PESCH
	Individual professional last name
Provider First Name	SERENA
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5419 N SHERIDAN RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 103A
	Group Practice or individual's line 2 address
City	CHICAGO
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	606407493
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8478599845
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y