NPIMap

Organization Active NPI

Children's Medical Group, S.C.

  • Pediatrics Physician
  • Lake in the Hills, IL
National Provider Identifier
1740483718
Registry record updated Jul 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036109900 Issued in IL
Legal business name
CHILDREN'S MEDICAL GROUP, S.C.
Practice address
301 N Randall Rd
Lake in the Hills, IL 60156-5961
Phone
(847) 658-6065
Fax
(847) 658-6136
NPI assigned
Jun 7, 2007
Last updated
Jul 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2016

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

Authorized official

Name
Dr. Jason C Tjaden, MDNPI 1447215033
Title
Owner
Phone
(847) 658-6065

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 Physician 208000000X 036109900 IL Primary

Addresses

Primary practice location

301 N Randall Rd
Lake in the Hills, IL 60156-5961

Mailing address

301 N Randall Rd
Lake in the Hills, IL 60156-5961
Phone (847) 658-6065

National Provider Directory

National Provider Directory

Locations

301 N Randall Rd
Lake in the Hills, IL 60156
Phone (847) 658-6065

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1740483718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 N RANDALL RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565961",
            "telephone_number": "847-658-6065",
            "fax_number": "847-658-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 N RANDALL RD",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601565961",
            "telephone_number": "847-658-6065",
            "fax_number": "847-658-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S MEDICAL GROUP, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "TJADEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-658-6065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036109900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake in the Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.