Organization Active NPI

Maternal and Child Medical Care, S.C

  • Obstetrics & Gynecology Physician
  • Addison, IL
National Provider Identifier
1912203209
Registry record updated Feb 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MATERNAL AND CHILD MEDICAL CARE, S.C
Practice address
2055 W Army Trail Rd
Suite 104
Addison, IL 60101-1478
Phone
(847) 650-1452
Fax
(224) 535-7260
NPI assigned
Feb 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2011

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

Authorized official

Name
Dr. Orawan Sukavachana, MD
Title
President/Ceo
Phone
(847) 650-1452

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

2055 W Army Trail Rd
Suite 104
Addison, IL 60101-1478

Mailing address

2055 West Army Trail Road
Suite 104
Addison, IL 60101
Phone (847) 650-1452

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": "1296691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296691200000",
    "number": "1912203209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 WEST ARMY TRAIL ROAD",
            "address_2": "SUITE 104",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "60101",
            "telephone_number": "847-650-1452",
            "fax_number": "224-535-7260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 W ARMY TRAIL RD",
            "address_2": "SUITE 104",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011478",
            "telephone_number": "847-650-1452",
            "fax_number": "224-535-7260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATERNAL AND CHILD MEDICAL CARE, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-03",
        "last_updated": "2011-02-03",
        "status": "A",
        "authorized_official_last_name": "SUKAVACHANA",
        "authorized_official_first_name": "ORAWAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "847-650-1452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2011; 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.