Provider Demographics
NPI:1932225448
Name:PEDIATRIC PARTNERS SC
Entity Type:Organization
Organization Name:PEDIATRIC PARTNERS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:SIROTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-362-4155
Mailing Address - Street 1:767 PARK AVE W
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2400
Mailing Address - Country:US
Mailing Address - Phone:847-681-7100
Mailing Address - Fax:847-681-7110
Practice Address - Street 1:870 W END CT
Practice Address - Street 2:SUITE 205
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1383
Practice Address - Country:US
Practice Address - Phone:847-362-4155
Practice Address - Fax:847-362-4425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty