Organization Active NPI

Friedrich J. Von Bun, M.D.,S.C.

  • Clinic/Center
  • Pekin, IL
National Provider Identifier
1942505664
Registry record updated Jan 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
24781673 Issued in IL
Legal business name
FRIEDRICH J. VON BUN, M.D.,S.C.
Doing business as
Pekin Pulmonary Clinic
Practice address
1327 Executive CT
Pekin, IL 61554-6096
Phone
(309) 353-5864
Fax
(309) 353-4894
NPI assigned
Jan 12, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2011

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

Authorized official

Name
Dr. Friedrich Josef Von Bun, M.D.
Title
Owner
Phone
(309) 353-5864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 24781673 IL Primary

Addresses

Primary practice location

1327 Executive CT
Pekin, IL 61554-6096

Mailing address

1327 Executive CT
Pekin, IL 61554-6096
Phone (309) 353-5864

Other identifiers 4

IdentifierTypeStateIssuer
1760489306OtherNPI
0360812671MedicaidIL
290008130OtherRAILROAD MEDICARE
944370OtherPTAN

Other names 1

  • Pekin Pulmonary Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

1327 Executive Ct
Pekin, IL 61554
Phone (309) 353-5864

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294790400000",
    "number": "1942505664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1327 EXECUTIVE CT",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546096",
            "telephone_number": "309-353-5864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1327 EXECUTIVE CT",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615546096",
            "telephone_number": "309-353-5864",
            "fax_number": "309-353-4894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIEDRICH J. VON BUN, M.D.,S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A",
        "authorized_official_last_name": "VON BUN",
        "authorized_official_first_name": "FRIEDRICH",
        "authorized_official_middle_name": "JOSEF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-353-5864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "24781673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1760489306",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360812671",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "290008130",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "944370",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pekin Pulmonary Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.