Provider Demographics
NPI:1295952471
Name:CHILDREN'S HEALTHCARE ASSOCIATES P.C.
Entity type:Organization
Organization Name:CHILDREN'S HEALTHCARE ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNETT
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-348-8300
Mailing Address - Street 1:2835 N SHEFFIELD AVE
Mailing Address - Street 2:#501
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5081
Mailing Address - Country:US
Mailing Address - Phone:773-348-8300
Mailing Address - Fax:773-348-7163
Practice Address - Street 1:2835 N SHEFFIELD AVE
Practice Address - Street 2:501
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5081
Practice Address - Country:US
Practice Address - Phone:773-348-8300
Practice Address - Fax:773-348-7163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01632699208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01632699OtherLICENSE NUMBER
IL01632699OtherLICENSE NUMBER