Apex Medical PC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

License

036087175 Issued in IL

Legal business name

APEX MEDICAL PC

Practice address

925 West St
Peru, IL 61354-2757

Phone

(815) 223-3300

NPI assigned

Sep 28, 2007

Last updated

Jan 19, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ronald F Kloc, DO

Title

Owner/Physician

Phone

(815) 223-3300

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232323200000",
    "number": "1053508523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770967",
            "telephone_number": "708-532-6029",
            "fax_number": "708-532-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 WEST ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613542757",
            "telephone_number": "815-223-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APEX MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2009-01-19",
        "status": "A",
        "authorized_official_last_name": "KLOC",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "815-223-3300",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IL",
            "license": "036087175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087175",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PROVIDER #",
            "identifier": "005032080",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Peru, IL
• Providers in Peru, IL by specialty
• Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.