Provider Demographics
NPI:1093844789
Name:RAINBOW PEDIATRICS, S.C.
Entity Type:Organization
Organization Name:RAINBOW PEDIATRICS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILAH
Authorized Official - Middle Name:BRIDGET
Authorized Official - Last Name:CINTRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-681-7690
Mailing Address - Street 1:675 W NORTH AVE
Mailing Address - Street 2:SUITE # 203
Mailing Address - City:MELROSE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60160-1634
Mailing Address - Country:US
Mailing Address - Phone:708-681-7690
Mailing Address - Fax:708-681-7655
Practice Address - Street 1:675 W NORTH AVE
Practice Address - Street 2:SUITE # 203
Practice Address - City:MELROSE PARK
Practice Address - State:IL
Practice Address - Zip Code:60160-1634
Practice Address - Country:US
Practice Address - Phone:708-681-7690
Practice Address - Fax:708-681-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0051649722OtherEXISTING BCBS PROVIDER #