Individual provider Active NPI

Peter Herbert Neale, D.O.

  • Family Medicine Physician
  • Lansing, IL
National Provider Identifier
1205803483
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
036073399 Issued in IL
Practice address
18127 William St
Lansing, IL 60438-3921
Phone
(708) 889-6621
Fax
(708) 889-6675
NPI assigned
Mar 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 02002162A IN
Family Medicine Physician 207Q00000X 036073399 IL Primary

Addresses

Primary practice location

18127 William St
Lansing, IL 60438-3921

Mailing address

27702 Network PL
Chicago, IL 60673-1277
Phone (708) 862-7674

Other identifiers 3

IdentifierTypeStateIssuer
231199029OtherILMEDICARE
080096730OtherILRRM
036073399MedicaidIL

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 Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
02002162AINMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Ingalls Memorial Hospital Past Accepting new patients
The Ingalls Memorial Hospital Past Accepting new patients
Ingalls Memorial Hospital Past Accepting new patients
Ingalls Memorial Hospital Past Accepting new patients
Ingalls Memorial Hospital Past Accepting new patients
Ingalls Memorial Hospital Past Accepting new patients
Ingalls Memorial Hospital Past Accepting new patients
The Ingalls Memorial Hospital Past Accepting new patients
Ingalls Memorial Hospital Past Accepting new patients
Ingalls Memorial Hospital Past Accepting new patients

Organizations & group practices 10

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": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1205803483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731277",
            "telephone_number": "708-862-7674",
            "fax_number": "708-862-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18127 WILLIAM ST",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604383921",
            "telephone_number": "708-889-6621",
            "fax_number": "708-889-6675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEALE",
        "first_name": "PETER",
        "middle_name": "HERBERT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-07",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02002162A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036073399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "231199029",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRM",
            "identifier": "080096730",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036073399",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.