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

Organization Otolaryngology Physician · NPI 1225426331

University of Penn-Medical Group is an Otolaryngology Physician in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2014.

Licensed in
PA
In the registry since
2014
Specialties on file
5
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Practice location Address checks out

3400 Spruce St 5 Silverstein Bldg
Philadelphia, PA 19104-4238
Phone: (215) 662-2777
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Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X (PA)
Facial Plastic Surgery Physician Taxonomy 207YS0123X (PA)
Otolaryngic Allergy Physician Taxonomy 207YX0602X (PA)
Otology & Neurotology Physician Taxonomy 207YX0901X (PA)
Otolaryngology/Facial Plastic Surgery Physician Taxonomy 207YX0905X (PA)

Record details

NPI number1225426331
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment Lead · (215) 662-6187
NPI enumeratedDecember 26, 2014
Last updated in NPPESNovember 19, 2020
Certification dateNovember 19, 2020
Mailing address3400 Spruce St, 5 Silverstein Building, Philadelphia, PA 19104-4238

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