D.O.C, Family Practice, S.C.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036075404 Issued in IL

Legal business name

D.O.C, FAMILY PRACTICE, S.C.

Practice address

6300 Roosevelt Rd
Oak Park, IL 60304-2303

Phone

(708) 383-6333

Fax

(708) 383-6347

NPI assigned

Apr 25, 2012

Last updated

Apr 25, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Crystal Ann Peoples, M.D.

Title

President

Phone

(708) 383-6333

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1861750036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2294",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603032294",
            "telephone_number": "708-383-6333",
            "fax_number": "708-383-6347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 ROOSEVELT RD",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603042303",
            "telephone_number": "708-383-6333",
            "fax_number": "708-383-6347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D.O.C, FAMILY PRACTICE, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "PEOPLES",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-383-6333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036075404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1588775696",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.