Provider Demographics
NPI:1821871849
Name:KIDS CHEST & SPINE INSTITUTE
Entity Type:Organization
Organization Name:KIDS CHEST & SPINE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:NATIONAL CONTRACTOR
Authorized Official - Phone:404-664-1693
Mailing Address - Street 1:290 W LOOP RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-2034
Mailing Address - Country:US
Mailing Address - Phone:404-664-1693
Mailing Address - Fax:
Practice Address - Street 1:290 W LOOP RD
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-2034
Practice Address - Country:US
Practice Address - Phone:404-664-1693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty