{"npi":"1801902432","type":"NPI-1","status":"active","name":{"display":"Dr. Mark Klucka D.O.","other":[],"first":"MARK","last":"KLUCKA","middle":"T","credential":"D.O."},"specialty":{"primary_taxonomy":"207Q00000X","primary_taxonomy_description":"Family Medicine","slug":"family-medicine","schema_org_specialty":"PrimaryCare","all":[{"code":"207Q00000X","description":"Family Medicine","primary":true,"state":"IL","license":"036077227"},{"code":"207RG0100X","description":"Gastroenterology","primary":false,"state":"IL","license":"036.077227"}]},"addresses":[{"purpose":"LOCATION","street_1":"4 MEMORIAL DR STE 230","city":"ALTON","state":"IL","postal_code":"620026704","country_code":"US","phone":"6184637874"},{"purpose":"MAILING","street_1":"PO BOX 959203","city":"SAINT LOUIS","state":"MO","postal_code":"631951281","country_code":"US","phone":"6184637874","fax":"6184637846"}],"license":{"state":"IL","number":"036077227"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"036077227","state":"IL","issuer":null},{"type_code":"01","label":"Other","value":"100013015","state":"IL","issuer":"RAILROAD MEDICARE"}],"pecos":{"enrolled_at":"2026-07-01T15:01:53.235063+00:00","enrollments":[{"enrlmt_id":"I20100319000401","type_code":"14-10","type_desc":"PRACTITIONER - GASTROENTEROLOGY","state":"IL","pac_id":"3678608353"},{"enrlmt_id":"I20240917002110","type_code":"14-08","type_desc":"PRACTITIONER - FAMILY PRACTICE","state":"IL","pac_id":"3678608353"}]},"enumeration_date":"2006-08-23","last_updated":"2025-09-19","_meta":{"source":"NPPES","snapshot_date":"2025-09-19","doc_url":"https://findmynpi.com/api"}}