Provider Demographics
NPI:1326228503
Name:GLENBROOK PEDIATRICS, S.C.
Entity Type:Organization
Organization Name:GLENBROOK PEDIATRICS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:847-729-6445
Mailing Address - Street 1:2551 COMPASS ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-8042
Mailing Address - Country:US
Mailing Address - Phone:847-729-6445
Mailing Address - Fax:847-729-1106
Practice Address - Street 1:2551 COMPASS ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-8042
Practice Address - Country:US
Practice Address - Phone:847-729-6445
Practice Address - Fax:847-729-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty