NPIMap

Organization Active NPI

Midwest Pediatric Cardiology, P.C.

  • Pediatric Cardiology Physician
  • Oak Lawn, IL
National Provider Identifier
1962483669
Registry record updated Sep 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
MIDWEST PEDIATRIC CARDIOLOGY, P.C.
Practice address
4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone
(708) 684-5580
Fax
(708) 684-4068
NPI assigned
Nov 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2007

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

Authorized official

Name
Dr. David Roberson, MDNPI 1578544292
Title
President
Phone
(708) 684-5580

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
Pediatric Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0202X Primary

Addresses

Primary practice location

4440 W 95TH St
Oak Lawn, IL 60453-2600

Mailing address

621 Plainfield Rd
#105
Willow Brook, IL 60527-5343
Phone (630) 321-9811

Other identifiers 1

IdentifierTypeStateIssuer
1617609OtherBCBS OF ILLINOIS

National Provider Directory

National Provider Directory

Locations

680 N Lake Shore Dr
Ste 1430
Chicago, IL 60611
Phone (312) 654-9100

1482 Momentum Pl
Chicago, IL 60689

2307 S Cicero Ave
Cicero, IL 60804
Phone (708) 780-9777

2500 Ridge Ave
Ste 109
Evanston, IL 60201
Phone (847) 328-4343

1106 N Larkin Ave
Joliet, IL 60435
Phone (815) 725-6188

4151 Naperville Rd
Lisle, IL 60532
Phone (630) 505-0440

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189728000000",
    "number": "1962483669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 PLAINFIELD RD",
            "address_2": "#105",
            "city": "WILLOW BROOK",
            "state": "IL",
            "postal_code": "605275343",
            "telephone_number": "630-321-9811",
            "fax_number": "630-321-9813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532600",
            "telephone_number": "708-684-5580",
            "fax_number": "708-684-4068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PEDIATRIC CARDIOLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2007-09-14",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-684-5580",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "1617609",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

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