NPIMap

Organization Active NPI

Pediatric Practice Alliance LLC

  • Pediatrics Physician
  • Palos Heights, IL
National Provider Identifier
1265946982
Registry record updated Nov 17, 2017
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Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC PRACTICE ALLIANCE LLC
Practice address
7110 W 127TH St
Palos Heights, IL 60463-1571
Phone
(630) 235-5000
NPI assigned
Nov 17, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2017

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

Authorized official

Name
Dr. Omprakash Sawlani, MD
Title
President
Phone
(630) 235-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

7110 W 127TH St
Palos Heights, IL 60463-1571

Mailing address

7110 W 127TH St
Palos Heights, IL 60463-1571
Phone (630) 235-5000

Other identifiers 1

IdentifierTypeStateIssuer
036057974MedicaidIL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510876800000",
    "number": "1265946982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 W 127TH ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631571",
            "telephone_number": "630-235-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 W 127TH ST",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631571",
            "telephone_number": "630-235-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PRACTICE ALLIANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2017-11-17",
        "status": "A",
        "authorized_official_last_name": "SAWLANI",
        "authorized_official_first_name": "OMPRAKASH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-235-5000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036057974",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; 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.