Organization Active NPI

Kid Care Doctors

  • Pediatrics Physician
  • Cicero, IL
National Provider Identifier
1043535248
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
KID CARE DOCTORS
Doing business as
Kid Care Pediatrics
Practice address
2240 S Cicero Ave
Cicero, IL 60804-2411
Phone
(708) 222-9170
Fax
(708) 222-9173
NPI assigned
Mar 30, 2010
Organization subpart
Yes
Parent organization
KID CARE PEDIATRICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Micheal Peters
Title
Cfo
Phone
(312) 274-0498

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Clinic/Center 261Q00000X

Addresses

Primary practice location

2240 S Cicero Ave
Cicero, IL 60804-2411

Mailing address

2254 S Cicero Ave
Cicero, IL 60804-2411
Phone (773) 222-9170

Other names 1

  • Kid Care Pediatrics Doing business as

National Provider Directory

National Provider Directory
Part of
Kid Care Doctors

Locations

2254 S Cicero Ave
Cicero, IL 60804
Phone (708) 656-2222

NPI Registry JSON

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

{
    "created_epoch": "1269907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1043535248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2254 S CICERO AVE",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042411",
            "telephone_number": "773-222-9170",
            "fax_number": "708-222-9173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 S CICERO AVE",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042411",
            "telephone_number": "708-222-9170",
            "fax_number": "708-222-9173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KID CARE DOCTORS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KID CARE PEDIATRICS",
        "enumeration_date": "2010-03-30",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "MICHEAL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "312-274-0498"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kid Care Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cicero, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.