Provider Demographics
NPI:1881168367
Name:PECULIS, JAMES FRANCIS (MPAS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:FRANCIS
Last Name:PECULIS
Suffix:
Gender:M
Credentials:MPAS
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Mailing Address - Street 1:1900 W POLK ST STE 465
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3723
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1969 W OGDEN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3765
Practice Address - Country:US
Practice Address - Phone:773-882-8698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-17
Last Update Date:2021-04-28
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant