Childrens Kidney Specialists SC

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

Legal business name

CHILDRENS KIDNEY SPECIALISTS SC

Practice address

1954 1St St
Suite 200
Highland Park, IL 60035-3104

Phone

(847) 433-3345

Fax

(847) 433-4426

NPI assigned

Sep 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ronald J Kallen, M.D.

Title

President Owner

Phone

(847) 433-3345

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1134316680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 OAKMONT LN",
            "address_2": "SUITE 1600",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595511",
            "telephone_number": "630-789-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1954 1ST ST",
            "address_2": "SUITE 200",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600353104",
            "telephone_number": "847-433-3345",
            "fax_number": "847-433-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS KIDNEY SPECIALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "KALLEN",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "847-433-3345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Nephrology Physician in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Pediatric Nephrology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.