Kenneth M Pelehac, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

49770 Issued in WI

Practice address

5404 Foxwoods Dr
Oak Lawn, IL 60453

Phone

(708) 382-1615

Fax

(888) 702-1052

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

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.

• Presence Central and Suburban Hospitals Network

  • Neonatal-Perinatal Medicine Physician
  • Joliet, IL
  • NPI 1447596630
  NPD (past)
• Surgical Consultants, LTD.

  • Specialist
  • Palos Heights, IL
  • NPI 1124177324
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1487651550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5404 FOXWOODS DR",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535073",
            "telephone_number": "708-382-1615",
            "fax_number": "888-702-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5404 FOXWOODS DR",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60453",
            "telephone_number": "708-382-1615",
            "fax_number": "888-702-1052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N2950 State Road 67",
            "address_purpose": "LOCATION",
            "city": "Lake Geneva",
            "state": "WI",
            "postal_code": "531472655",
            "country_code": "US",
            "telephone_number": "262-245-0535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELEHAC",
        "first_name": "KENNETH",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036085109",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "IL",
            "license": "036085109",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "49770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Subspecialty and Hospitalist Association LLC
• Pediatrics on Demand Urgent Care
• Pediatrics on Demand, Inc.
• Ari S Peikes, MD
• Mark H Pelech, LSW CADC
• Emily Pena, PA-C
• Joselyn Marie Pena, PA-C
• Benjamin Peng, M.D.
• Kelly Pennington, PT
• Susan Ann Pennington, PT

• Surgery Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.