Robert D Peck, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038005202 Issued in IL

Practice address

678 N Northwest Hwy
Unit C
Park Ridge, IL 60068-2540

Phone

(847) 696-0040

Fax

(847) 696-2519

NPI assigned

Apr 6, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 1984

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362960000000",
    "number": "1710009964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 N NORTHWEST HWY",
            "address_2": "UNIT C",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682540",
            "telephone_number": "847-696-0040",
            "fax_number": "847-696-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 N NORTHWEST HWY",
            "address_2": "UNIT C",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682540",
            "telephone_number": "847-696-0040",
            "fax_number": "847-696-2519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "ROBERT",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2013-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038005202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1683628",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elena Maria Pawloski
• Anna T. Payne, NP
• Alexandra Pazaran, LPC
• Joseph Peabody
• Denise L. Pearl, LPC
• Calista Louise Pecoraro
• Pediatric Critical Care Specialists
• Pediatric Dental Associates, PC
• Pediatric Ophthalmology, Adult Strabismus Center LTD.
• Pediatric Urology Partners

• Chiropractor in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.