Provider Demographics
NPI:1073573564
Name:PEDIATRIC ASSOCIATES OF ARLINGTON HTS SC
Entity Type:Organization
Organization Name:PEDIATRIC ASSOCIATES OF ARLINGTON HTS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PEDIATRIC ASSOCIATES OF A
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GAYLORD
Authorized Official - Last Name:RAMSAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-259-5070
Mailing Address - Street 1:880 W CENTRAL RD
Mailing Address - Street 2:STE 4200
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2381
Mailing Address - Country:US
Mailing Address - Phone:847-259-5070
Mailing Address - Fax:847-259-5322
Practice Address - Street 1:880 W CENTRAL RD
Practice Address - Street 2:STE 4200
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2381
Practice Address - Country:US
Practice Address - Phone:847-259-5070
Practice Address - Fax:847-259-5322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherTAX ID