Pediatric Specialist of the NW Mdsc
Pediatric Specialist of the NW Mdsc provides Pediatrics Physician services in Crystal Lake, Illinois. Licensed in Illinois. Registered with an NPI since 2005.
- Licensed in
- IL
- In the registry since
- 2005
Practice location Address checks out
475 W Terra Cotta Ave Ste 01Crystal Lake, IL 60014-3407
Phone: (847) 381-5005
Fax: (847) 381-5036
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Pediatrics Physician (primary) | Taxonomy 208000000X (IL) |
|---|
Record details
| NPI number | 1598765521 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Charles Braverman — Authorized Official · (843) 381-5005 |
| NPI enumerated | August 1, 2005 |
| Last updated in NPPES | July 21, 2022 |
| Mailing address | 5057 Shoreline Rd, Lake Barrington, IL 60010-1700 |
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