Provider Demographics
NPI:1225144728
Name:NEW PEDIATRIC ASSOCIATES LLC
Entity Type:Organization
Organization Name:NEW PEDIATRIC ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZUHAIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALSAKAJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-795-1660
Mailing Address - Street 1:7863 BROADWAY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-5553
Mailing Address - Country:US
Mailing Address - Phone:219-795-1660
Mailing Address - Fax:219-795-1630
Practice Address - Street 1:7863 BROADWAY
Practice Address - Street 2:SUITE 140
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5553
Practice Address - Country:US
Practice Address - Phone:219-795-1660
Practice Address - Fax:219-795-1630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01046051A261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
90001185OtherBLUE CROSS OF ILLINOIS
IN200207090Medicaid
000000338446OtherANTHEM
IL036094958Medicaid
IL036094958Medicaid