MEDICARE: PETER B RONCO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	01060851	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821192337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER B RONCO MD

Provider Business Mailing Address
First Line	:	PO BOX 719094
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-9318
Country	:	US
Telephone Number	:	317-777-6435
Fax Number	:	317-777-6644

Provider Business Practice Location Address
First Line	:	1701 N SENATE AVE
Second Line	:	DEPT OF PEDIATRICS
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5306
Country	:	US
Telephone Number	:	317-962-8067
Fax Number	:	317-962-3796

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	02/06/2026

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Directions to “ PETER B RONCO MD” Practice Location

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