Provider Demographics
NPI:1568890325
Name:PEDIATRICS PLUS. S.C.
Entity Type:Organization
Organization Name:PEDIATRICS PLUS. S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PRACTIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SCHOTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-517-6177
Mailing Address - Street 1:4011 AVENUE OF THE CITIES STE 101B
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-4454
Mailing Address - Country:US
Mailing Address - Phone:309-517-6177
Mailing Address - Fax:309-517-6178
Practice Address - Street 1:4011 AVENUE OF THE CITIES STE 101B
Practice Address - Street 2:SUITE 101B
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-4454
Practice Address - Country:US
Practice Address - Phone:309-517-6177
Practice Address - Fax:309-517-6178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095373208000000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1033179544OtherINDIVIDUAL NPI NUMBER
ILG58099Medicare UPIN