Provider Demographics
NPI:1326656125
Name:KIDS PEDIATRICS LTD
Entity Type:Organization
Organization Name:KIDS PEDIATRICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:PASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-995-7066
Mailing Address - Street 1:288 W LOOP RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2034
Mailing Address - Country:US
Mailing Address - Phone:630-868-3620
Mailing Address - Fax:
Practice Address - Street 1:288 W LOOP RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-2034
Practice Address - Country:US
Practice Address - Phone:630-868-3620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty