Individual provider Active NPI

Anibal A Pepper, MD

  • Surgery Physician
  • River Forest, IL
National Provider Identifier
1619267325
Registry record updated Apr 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
036.047045 Issued in IL
Practice address
918 William St
River Forest, IL 60305-1457
Phone
(708) 771-5345
Fax
(708) 771-5053
NPI assigned
Apr 14, 2011
Last updated
Apr 14, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 036.047045 IL Primary

Addresses

Primary practice location

918 William St
River Forest, IL 60305-1457

Mailing address

918 William St
River Forest, IL 60305-1457
Phone (708) 771-5345

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.047045ILMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1302739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302739200000",
    "number": "1619267325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 WILLIAM ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051457",
            "telephone_number": "708-771-5345",
            "fax_number": "708-771-5053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 WILLIAM ST",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051457",
            "telephone_number": "708-771-5345",
            "fax_number": "708-771-5053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPPER",
        "first_name": "ANIBAL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-14",
        "last_updated": "2011-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036.047045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2011; 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.