Nicholas P Pruc, D.O.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

036084411 Issued in IL

Practice address

422 Stratford Rd
Des Plaines, IL 60016-2004

Phone

(847) 803-8156

NPI assigned

Nov 6, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• American Home Visiting Physicians

  • General Practice Physician
  • Des Plaines, IL
  • NPI 1144525510
  NPD (past)

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

{
    "created_epoch": "1257465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257465600000",
    "number": "1396072641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 STRATFORD RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162004",
            "telephone_number": "847-803-8156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 STRATFORD RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162004",
            "telephone_number": "847-803-8156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUC",
        "first_name": "NICHOLAS",
        "middle_name": "P",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036084411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Principle Performance, Inc
• Prism Pharmcy Des Plaines Inc
• Procare Home Health Inc (VNA Healthtrends, LTD)
• Professional Home Health Care, Inc
• Proviso Family Services (Resurrection Behavioral Health)
• Psych First Behavioral Health, PLLC
• Jacqueline Puente
• Maryrose Puglia
• Noor S Qasim
• Quality Medical Care, SC

• Internal Medicine Physician in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Internal Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.