Basic Information
| Provider Information | |||||||||
| NPI: | 1821036047 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STECY | ||||||||
| FirstName: | PETER | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3118 N ASHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606573014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738809722 | ||||||||
| FaxNumber: | 7738809723 | ||||||||
| Practice Location | |||||||||
| Address1: | 3118 N ASHLAND AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606573014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738809722 | ||||||||
| FaxNumber: | 7738809723 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/02/2006 | ||||||||
| LastUpdateDate: | 06/28/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 036073386 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 1487951711 | 01 | IL | NPI | OTHER | 1602375 | 01 | IL | BSBC | OTHER |