Provider Demographics
NPI:1720276553
Name:INFANTS & CHILDRENS CLINIC
Entity Type:Organization
Organization Name:INFANTS & CHILDRENS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MALGORZATA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PATEREK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-357-8714
Mailing Address - Street 1:901 BIESTERFIELD RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-3392
Mailing Address - Country:US
Mailing Address - Phone:847-357-8714
Mailing Address - Fax:847-357-8719
Practice Address - Street 1:901 BIESTERFIELD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-3392
Practice Address - Country:US
Practice Address - Phone:847-357-8714
Practice Address - Fax:847-357-8719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty