Lagrange Pediatrics LTD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

LAGRANGE PEDIATRICS LTD

Practice address

4727 Willow Springs Road
La Grange, IL 60525

Phone

(708) 588-0088

Fax

(708) 588-0588

NPI assigned

Oct 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark C Matray, MD

Title

Physician President

Phone

(708) 588-0088

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David E Kaczor, MD

  • Pediatrics Physician
  • Lagrange, IL
  • NPI 1053491662
  NPD (past)
• Heather Rizvi, M.D.

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1265844435
  NPD (past)
• Julie Christine Tumma, MD

  • Pediatrics Physician
  • Lagrange, IL
  • NPI 1336151489
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033299649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4727 WILLOW SPRINGS ROAD",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "60525",
            "telephone_number": "708-588-0088",
            "fax_number": "708-588-0588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 WILLOW SPRINGS ROAD",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "60525",
            "telephone_number": "708-588-0088",
            "fax_number": "708-588-0588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGRANGE PEDIATRICS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATRAY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN  PRESIDENT",
        "authorized_official_telephone_number": "708-588-0088",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kris Maynard LCSW LTD
• Catherine Kupczyk, OTR/L, CET,CLT-LANA
• Lactation Care Connection, LLC
• Lagrange Area Dept Spec Ed
• Lagrange Oncology Associates, S.C.
• Lagrange School District 105
• Lagrange School District 105
• Angella Brickner Lally, MA CCC-SLP
• Lamco Wellness
• Heidi Land, RBT

• Pediatrics Physician in La Grange, IL
• Providers in La Grange, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.