Organization
APEX MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD F KLOC DO (OWNER/PHYSICIAN)
(815) 223-3300
Entity
Organization
Contact information
Practice address
925 WEST ST, PERU, IL 61354-2757
(815) 223-3300
Mailing address
PO BOX 967, TINLEY PARK, IL 60477-0967
(708) 532-6029
(708) 532-6095
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
036087175
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005032080
BLUE CROSS BLUE SHIELD PROVIDER #
IL
05
—
036087175
—
IL
Enumeration date
09/28/2007
Last updated
01/19/2009
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