Dr. Peter Charles Revenaugh
Otolaryngologist (ENT Doctor) Otolaryngology/Facial Plastic Surgery
1611 W Harrison St Ste 550
Chicago
, Illinois 60612
Dr. Peter Charles Revenaugh
Otolaryngologist (ENT Doctor) Otolaryngology/Facial Plastic Surgery
1611 W Harrison St Ste 550
Chicago
, Illinois 60612
(312) 942-6100
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
- Otolaryngology/Facial Plastic Surgery
Languages spoken
- English
Location
First Address
- Dr. Peter Charles Revenaugh
- 1611 W Harrison St Ste 550
- Chicago, IL
- Zip : 60612-4861
- Phone : (312) 942-6100
Second Address
- Dr. Peter Charles Revenaugh
- 1611 W Harrison St Ste 550
- Chicago, IL
- Zip : 60612
- Phone : (312) 942-6100
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207Y00000X | Otolaryngologist (ENT Doctor) | 036-136085 | IL |
| Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 036-136085 | IL |
National Provider Identifier
| NPI | 1114198678 |
|---|---|
| Provider Name | Dr. Peter Charles Revenaugh |
| First Address | Chicago, IL 60612-4861 |
| Second Address | Chicago, IL 60612 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/03/2008 |
| Last Update Date | 30/01/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.