Provider Demographics
NPI:1386868404
Name:J & K PEDIATRICS AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:J & K PEDIATRICS AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAWITTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-759-9407
Mailing Address - Street 1:4119 W SHAMROCK LN
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8289
Mailing Address - Country:US
Mailing Address - Phone:815-759-9407
Mailing Address - Fax:815-759-9475
Practice Address - Street 1:4119 W SHAMROCK LN
Practice Address - Street 2:SUITE 201
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8289
Practice Address - Country:US
Practice Address - Phone:815-759-9407
Practice Address - Fax:815-759-9475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036104503208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty