Basic Information
| Provider Information | |||||||||
| NPI: | 1851320956 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PECKUS | ||||||||
| FirstName: | JOLANTA | ||||||||
| MiddleName: | A. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15 S MCHENRY | ||||||||
| Address2: | IMMEDIATE CARE | ||||||||
| City: | BUFFALO GROVE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600893115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8474596100 | ||||||||
| FaxNumber: | 8475414857 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 W CENTRAL RD | ||||||||
| Address2: | NORTHWEST COMMUNITY HOSPITAL | ||||||||
| City: | ARLINGTON HEIGHTS | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600052349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8476184000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2006 | ||||||||
| LastUpdateDate: | 03/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 036-040205 | IL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.