Provider Demographics
NPI:1609917491
Name:MIDWESTPEDIATRICS,LTD
Entity Type:Organization
Organization Name:MIDWESTPEDIATRICS,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:VARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-355-1093
Mailing Address - Street 1:1020 E OGDEN AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8611
Mailing Address - Country:US
Mailing Address - Phone:630-355-1093
Mailing Address - Fax:
Practice Address - Street 1:1020 E OGDEN AVE STE 306
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8611
Practice Address - Country:US
Practice Address - Phone:630-355-1093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty