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PALOS PEDIATRIC ASSOCIATES NPI 1093067233


NPI Information

NPI: 1093067233
Provider Name: PALOS PEDIATRIC ASSOCIATES
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 14D2062345

Address:
4700 W 95TH ST. STE 301
OAK LAWN, IL
ZIP 60453
Phone: (708) 424-7601
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PALOS PEDIATRIC ASSOCIATES is a pediatrics in Oak Lawn, IL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. PALOS PEDIATRIC ASSOCIATES NPI is 1093067233. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4700 W 95TH ST. STE 301
OAK LAWN, IL
ZIP 60453
Phone: (708) 424-7601
Fax: (708) 675-1008

The provider's authorized official is Mazen Rachid .
The authorized official title is Pediatrician and has the following contact phone number (708) 424-7601.

The CLIA number assigned to this NPI record is 14D2062345 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/11/2012 and was last updated on 1/31/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist036099854ILLINOISNo
2208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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