Provider Demographics
NPI:1982721528
Name:PEDIATRIC CARE ASSOCIATES, SC
Entity Type:Organization
Organization Name:PEDIATRIC CARE ASSOCIATES, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-884-7710
Mailing Address - Street 1:2500 W HIGGINS RD
Mailing Address - Street 2:SUITE 670
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-5220
Mailing Address - Country:US
Mailing Address - Phone:847-884-7710
Mailing Address - Fax:847-884-8094
Practice Address - Street 1:2500 W HIGGINS RD
Practice Address - Street 2:SUITE 670
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60195-5220
Practice Address - Country:US
Practice Address - Phone:847-884-7710
Practice Address - Fax:847-884-8094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21609488OtherBCBS PROVIDER ID