Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Med-Ped Medical Center SC

Organization Internal Medicine Physician · NPI 1629641477

Med-Ped Medical Center SC is an Internal Medicine Physician in Chicago, Illinois. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

5939 W Diversey Ave
Chicago, IL 60639-1155
Phone: (773) 637-1600
Fax: (773) 637-1520
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1629641477
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Walter Plasencia — Owner · (773) 637-1600
NPI enumeratedJuly 20, 2021
Last updated in NPPESJuly 20, 2021
Certification dateJuly 20, 2021
Mailing address5939 W Diversey Ave, Chicago, IL 60639-1155

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