Provider Demographics
NPI:1154450831
Name:RONALD J PEPLOW DO SC
Entity Type:Organization
Organization Name:RONALD J PEPLOW DO SC
Other - Org Name:RONALD J PEPLOW DO SC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:PEPLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:773-889-3121
Mailing Address - Street 1:7107 W BELMONT AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4688
Mailing Address - Country:US
Mailing Address - Phone:773-889-3121
Mailing Address - Fax:773-889-3914
Practice Address - Street 1:7107 W. BELMONT AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4688
Practice Address - Country:US
Practice Address - Phone:773-889-3121
Practice Address - Fax:773-889-3914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty