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

University of Penn - Medical Group

Organization Family Medicine Physician · NPI 1497767495

University of Penn - Medical Group is a Family Medicine Physician in Philadelphia, Pennsylvania. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
4

Practice location Address checks out

3615 Chestnut St Ralston-Penn Ctr
Philadelphia, PA 19104-2612
Phone: (215) 662-2746
Fax: (215) 349-5648
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Internal Medicine) Physician (primary) Taxonomy 207RG0300X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Pulmonary Disease Physician Taxonomy 207RP1001X

Record details

NPI number1497767495
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Chante Jackson — Enrollment Lead · (215) 662-6187
NPI enumeratedAugust 12, 2006
Last updated in NPPESNovember 19, 2020
Certification dateNovember 19, 2020
Mailing address3615 Ralston Center, Ralston Penn Center, Philadelphia, PA 19104-2612

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