Provider Demographics
NPI:1669864815
Name:PEARCE PEDIATRICS LLC
Entity Type:Organization
Organization Name:PEARCE PEDIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-385-2594
Mailing Address - Street 1:PO BOX 1033
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-0896
Mailing Address - Country:US
Mailing Address - Phone:630-385-2594
Mailing Address - Fax:630-385-2778
Practice Address - Street 1:4511 SAUK TRL
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1167
Practice Address - Country:US
Practice Address - Phone:708-747-6000
Practice Address - Fax:708-747-6003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2015-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036104943208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036104943Medicaid