Pediatric Providers of Danville, LTD

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

036113601 Issued in IL

Legal business name

PEDIATRIC PROVIDERS OF DANVILLE, LTD

Practice address

737 N Logan Ave
Danville, IL 61832-4363

Phone

(217) 442-0433

Fax

(217) 442-0485

NPI assigned

Apr 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Holly Mae Maes, MD

Title

President and Medical Director

Phone

(217) 442-0433

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1659638401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324363",
            "telephone_number": "217-442-0433",
            "fax_number": "217-442-0485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324363",
            "telephone_number": "217-442-0433",
            "fax_number": "217-442-0485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PROVIDERS OF DANVILLE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "MAES",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "PRESIDENT AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "217-442-0433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "036113601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harikrishna P Patel, MD
• Tarunkumar Sharadchandra Patel, M.D.
• Melissa Patterson
• Madhavi Paturi
• Presley E Pearman, PA-C
• Mark A Pellegrini, O.D.
• Nathalie Pelletier, D.C.
• Patrice Shanee Pelmore
• Austin Pena
• Beth Peralta, MS, RD, LDN

• Clinic/Center in Danville, IL
• Providers in Danville, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.