Provider Demographics
NPI:1578157053
Name:MIDWEST CARE PEDIATRICS INC
Entity Type:Organization
Organization Name:MIDWEST CARE PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REEMA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-795-5502
Mailing Address - Street 1:3340 OAK PARK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3483
Mailing Address - Country:US
Mailing Address - Phone:708-795-5502
Mailing Address - Fax:708-795-5516
Practice Address - Street 1:3340 OAK PARK AVE STE 201
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3483
Practice Address - Country:US
Practice Address - Phone:708-795-5502
Practice Address - Fax:708-795-5516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty