Ad-Park Pediatric Associates, S.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

AD-PARK PEDIATRIC ASSOCIATES, S.C.

Practice address

303 W Lake St
Suite 102
Addison, IL 60101-2586

Phone

(630) 543-3020

Fax

(630) 543-1551

NPI assigned

Apr 4, 2007

Organization subpart

No

Name

Dr. Merrick J Bromberg, D.O.NPI 1659481778

Title

Physician-Vice President

Phone

(630) 543-3020

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

• Merrick Jay Bromberg, D.O.

  • Pediatrics Physician
  • Addison, IL
  • NPI 1659481778

  Pediatrics

  NPD (past) Authorized official
• Paula Ann Bebej, DO

  • Pediatrics Physician
  • Schaumburg, IL
  • NPI 1881771459

  Pediatrics

  NPD (past)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700908498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W LAKE ST",
            "address_2": "SUITE 102",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012586",
            "telephone_number": "630-543-3020",
            "fax_number": "630-543-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W LAKE ST",
            "address_2": "SUITE 102",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601012586",
            "telephone_number": "630-543-3020",
            "fax_number": "630-543-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AD-PARK PEDIATRIC ASSOCIATES, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROMBERG",
        "authorized_official_first_name": "MERRICK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PHYSICIAN-VICE PRESIDENT",
        "authorized_official_telephone_number": "630-543-3020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Addison, IL
• Pediatrics Physician in Illinois

• 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.