NPIMap

Organization Active NPI

Pedro G. Palu-Ay M.D.S.C.

  • Specialist
  • Zion, IL
National Provider Identifier
1174726467
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
36047040 Issued in IL
Legal business name
PEDRO G. PALU-AY M.D.S.C.
Practice address
2606 Elisha Ave
Zion, IL 60099-2608
Phone
(847) 872-4558
Fax
(847) 872-2042
NPI assigned
Jun 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Mrs. Rita Lorain Gilmore
Title
Manager
Phone
(847) 731-8867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 36047040 IL Primary

Addresses

Primary practice location

2606 Elisha Ave
Zion, IL 60099-2608

Mailing address

2606 Elisha Ave
Zion, IL 60099-2608
Phone (847) 872-4558

National Provider Directory

National Provider Directory

Locations

2504 Washington St
Ste 402
Waukegan, IL 60085
Phone (847) 249-1733

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1174726467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 ELISHA AVE",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600992608",
            "telephone_number": "847-872-4558",
            "fax_number": "847-872-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 ELISHA AVE",
            "city": "ZION",
            "state": "IL",
            "postal_code": "600992608",
            "telephone_number": "847-872-4558",
            "fax_number": "847-872-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDRO G. PALU-AY M.D.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "GILMORE",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "LORAIN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-731-8867",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "36047040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.