A to Z Pediatric and Youth Healthcare
Organization Active NPI Primary Care Clinic/Center · Addison, IL
NPI 1962728386 · NPPES record last updated Feb 16, 2011
Key facts
- NPI
- 1962728386
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 036-097752 (IL)
- Legal business name
- A TO Z PEDIATRIC AND YOUTH HEALTHCARE
- Practice address
- 721 W Lake St
Suite 202
Addison, IL 60101-2035 - Phone
- (630) 757-4010
- Fax
- (630) 757-4011
- NPI assigned
- Apr 9, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Walter D Perez, MD
- Title
- President
- Phone
- (630) 757-4010
Practitioners 4
-
Elizabeth Galvan Castro, PA-C
-
Jill Whelan, APN
National Provider Directory
Locations
721 W Lake St
Ste 202
Addison, IL 60101
Phone (630) 757-4010
8863 Ogden Ave
Brookfield, IL 60513
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 036-097752 | IL | Yes |
| Primary Care Clinic/Center | 261QP2300X | 042619155 | IL |
Addresses
Primary practice location
721 W Lake St
Suite 202
Addison, IL 60101-2035
Mailing address
721 W Lake St
Suite 202
Addison, IL 60101-2035
Phone (630) 757-4010
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03-6097752 | Medicaid | IL |
Other names
- WALTER D PEREZ MD SC
Other providers in Addison, IL
- 1St Family Dental of Addison PC
- Cindy Abundiz
- Access Community Health Network
- Access Community Health Network
- Access Dental Center
- Ad-Park Pediatric Associates, S.C.
All providers in Addison, IL · Primary Care Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.