Chicago Pediatric Clinic Corp

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

CHICAGO PEDIATRIC CLINIC CORP

Practice address

1918 W Irving Park Road
Chicago, IL 60613

Phone

(773) 477-4900

Fax

(773) 477-4478

NPI assigned

Nov 29, 2007

Last updated

Nov 29, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darlene Egues, MDNPI 1700872900

Title

President

Phone

(773) 960-2555

Specialties & licenses 1

Addresses

Tax ID family

Chicago Pediatric Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Chicago Pediatric Clinic

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1780724898
  NPD tax ID

Practitioners 1

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.

• Darlene Egues, MD

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1700872900
  Authorized official Same address or phone

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1851573133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 W IRVING PARK ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "773-477-4900",
            "fax_number": "773-477-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 W IRVING PARK ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "773-477-4900",
            "fax_number": "773-477-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO PEDIATRIC CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "EGUES",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-960-2555",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Pain Medicine Center
• Chicago Pain Medicine Center
• Chicago PCR Lab Services Inc
• Chicago Pediatric & Neonatology SC
• Chicago Pediatric Clinic
• Chicago Pediatric Clinic I
• Chicago Pediatric Dentistry and Orthodontics PLLC (Chicago Pediatric Dentistry and Orthodontics)
• Chicago Pediatric Therapy & Wellness Center, LLC
• Chicago Performance and Rehab PLLC
• Chicago Perinatal Therapy, PLLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; 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.