Ebs Pediatrics

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

EBS PEDIATRICS

Practice address

6720 167TH St
Tinley Park, IL 60477-2872

Phone

(708) 429-1600

NPI assigned

May 23, 2006

Last updated

Jan 23, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Evan B Suan, MDNPI 1457358574

Title

Owner / Physician

Phone

(708) 429-1600

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Evan B Suan, MD

  • Pediatrics Physician
  • Tinley Park, IL
  • NPI 1457358574
  NPD (past) Authorized official

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1184679979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770967",
            "telephone_number": "708-532-6029",
            "fax_number": "708-532-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 167TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604772872",
            "telephone_number": "708-429-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBS PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "SUAN",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "708-429-1600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "0001633131",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.