NPIMap

Organization Active NPI

Parkside Pediatrics, S.C.

  • Pediatrics Physician
  • Park Ridge, IL
National Provider Identifier
1649392002
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PARKSIDE PEDIATRICS, S.C.
Practice address
1875 Dempster St
Suite 650
Park Ridge, IL 60068-1186
Phone
(847) 823-8000
NPI assigned
Apr 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Patricia Cotsirilos Stec, MDNPI 1053416123
Title
President
Phone
(847) 823-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

1875 Dempster St
Suite 650
Park Ridge, IL 60068-1186

Mailing address

1875 Dempster St
Suite 650
Park Ridge, IL 60068-1186
Phone (847) 823-8000

Other identifiers 2

IdentifierTypeStateIssuer
L021602OtherILTRICARE
31601770OtherILBLUE CROSS BLUE SHIELD IL

National Provider Directory

National Provider Directory

Locations

1875 W Dempster St
Ste 650
Park Ridge, IL 60068
Phone (847) 823-8000

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649392002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST",
            "address_2": "SUITE 650",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-823-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST",
            "address_2": "SUITE 650",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681186",
            "telephone_number": "847-823-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE PEDIATRICS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEC",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "COTSIRILOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-823-8000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "L021602",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "31601770",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.