Pediatric and Adolescent Healthy Lifestyle Center, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-096730 Issued in IL

Legal business name

PEDIATRIC AND ADOLESCENT HEALTHY LIFESTYLE CENTER, LLC

Practice address

2525 Ogden Ave
Downers Grove, IL 60515-1708

Phone

(847) 207-1121

Fax

(630) 310-8614

NPI assigned

Jan 20, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Morounkeji Akin-Olugbemi, MD, MPHNPI 1447232392

Title

Medical Director

Phone

(847) 207-1121

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Morounkeji E Akin-Olugbemi, M.D, MPH

  • Pediatrics Physician
  • Downers Grove, IL
  • NPI 1447232392
  NPD (past) Authorized official

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

{
    "created_epoch": "1358640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359331200000",
    "number": "1649518010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 OGDEN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151708",
            "telephone_number": "847-207-1121",
            "fax_number": "630-310-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 OGDEN AVE",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151708",
            "telephone_number": "847-207-1121",
            "fax_number": "630-310-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC AND ADOLESCENT HEALTHY LIFESTYLE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-20",
        "last_updated": "2013-01-28",
        "status": "A",
        "authorized_official_last_name": "AKIN-OLUGBEMI",
        "authorized_official_first_name": "MOROUNKEJI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-207-1121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, MPH"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-096730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adlin Pazmino, PA
• Pearl of Downers Grove LLC
• Nancy E Pecen, M.D.
• Gary A. Pecho, L.AC., MSOM
• Pediaprogress, Inc.
• Pediatric Rehabilitation Services
• Natalie Amanda Pekala
• Chad Pendley, M.D.
• Lauren Elizabeth Penkas
• Pentom Health Services LLC

• Pediatrics Physician in Downers Grove, IL
• Providers in Downers Grove, 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 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.