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NPI Code Detail

MEDICARE: ANDREW MICHAEL PECK MD

MEDICARE: ANDREW MICHAEL PECK 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
1207R00000XInternal Medicine Physician036119166IL
2207RN0300XNephrology Physician036119166IL

Other Identifiers

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

General Provider Information

NPI Number : 1114191632
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW MICHAEL PECK MD
Provider Business Mailing Address
First Line : 120 W 22ND ST
Second Line : NEPHROLOGY ASSOCIATES OF NORTHERN ILLINOIS
City : OAK BROOK
State : IL
Zip : 60523-1557
Country : US
Telephone Number : 630-573-5000
Fax Number :
Provider Business Practice Location Address
First Line : 601 W GOLF RD STE 105
Second Line : NEPHROLOGY ASSOC. OF NORTHERN ILLINOIS
City : MOUNT PROSPECT
State : IL
Zip : 60056-4276
Country : US
Telephone Number : 847-439-8780
Fax Number : 847-298-6395
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/15/2008
Last Update Date : 04/29/2025

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