Organization Active NPI

A2Z Care Med-Peds Specialists, PC

  • Pediatric Cardiology Physician
  • Bolingbrook, IL
National Provider Identifier
1386187458
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
036114636 Issued in IL
Legal business name
A2Z CARE MED-PEDS SPECIALISTS, PC
Practice address
550 East Bougton Road
Suite 110
Bolingbrook, IL 60440-2194
Phone
(630) 755-5437
NPI assigned
Nov 22, 2016
Last updated
Apr 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Mrs. Grace Hernandez
Title
Revenue Cycle Management Consultant
Phone
(708) 712-4010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X 036114636 IL Primary

Addresses

Primary practice location

550 East Bougton Road
Suite 110
Bolingbrook, IL 60440-2194

Mailing address

3250 Lacey Rd
Suite 160
Downers Grove, IL 60515-7901
Phone (708) 712-4010

Other identifiers 1

IdentifierTypeStateIssuer
036114636MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1386187458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 LACEY RD",
            "address_2": "SUITE 160",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605157901",
            "telephone_number": "708-712-4010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 EAST BOUGTON ROAD",
            "address_2": "SUITE 110",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402194",
            "telephone_number": "630-755-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A2Z CARE MED-PEDS SPECIALISTS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-22",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "REVENUE CYCLE MANAGEMENT CONSULTANT",
        "authorized_official_telephone_number": "708-712-4010",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "IL",
            "license": "036114636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036114636",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

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