Individual provider Active NPI

Bruce Dale Peoples, M.D.

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1063546240
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
36094936 Issued in IL
Practice address
5002 W Madison St
Chicago, IL 60644-4127
Phone
(773) 379-1000
Fax
(773) 379-1342
NPI assigned
Mar 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 36094936 IL Primary

Addresses

Primary practice location

5002 W Madison St
Chicago, IL 60644-4127

Mailing address

1333 Butterfield Rd
Ste 130
Downers Grove, IL 60515-5641
Phone (630) 371-0133

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36094936ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Cornerstone Recovering Community PastSince Oct 1, 2024 Accepting new patients
Circle Family Healthcare Network, Inc Past Accepting new patients
Human Enhancement Services NFP Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15508/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1063546240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1333 BUTTERFIELD RD",
            "address_2": "STE 130",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155641",
            "telephone_number": "630-371-0133",
            "fax_number": "630-371-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5002 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606444127",
            "telephone_number": "773-379-1000",
            "fax_number": "773-379-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEOPLES",
        "first_name": "BRUCE",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "36094936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; 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.