Organization Active NPI

Pace Pediatrics, P.C.

  • Home Health Agency
  • Indian Head Park, IL
National Provider Identifier
1710103098
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
056004383 Issued in IL
Legal business name
PACE PEDIATRICS, P.C.
Practice address
6341 Keokuk Rd
Indian Head Park, IL 60525-4341
Phone
(708) 790-4834
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Authorized official

Name
Krista L Murphy, M.S., OTR/LNPI 1396882429
Title
Owner
Phone
(708) 790-4834

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Home Health Agency 251E00000X 056004383 IL Primary

Addresses

Primary practice location

6341 Keokuk Rd
Indian Head Park, IL 60525-4341

Mailing address

6341 Keokuk Rd
Indian Head Park, IL 60525-4341
Phone (708) 790-4834

Other identifiers 1

IdentifierTypeStateIssuer
306809461001MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733184000000",
    "number": "1710103098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6341 KEOKUK RD",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "605254341",
            "telephone_number": "708-790-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6341 KEOKUK RD",
            "city": "INDIAN HEAD PARK",
            "state": "IL",
            "postal_code": "605254341",
            "telephone_number": "708-790-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACE PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "KRISTA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-790-4834",
        "authorized_official_credential": "M.S., OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "056004383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306809461001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Head Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2024; 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.