Pediatrust, L.L.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRUST, L.L.C.

Practice address

900 N Westmoreland Rd
Suite 217
Lake Forest, IL 60045-1674

Phone

(847) 615-0700

NPI assigned

Oct 26, 2012

Last updated

Mar 22, 2024By 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

Dr. Susan Sirota, M.D.NPI 1396715595

Title

Ceo

Phone

(224) 330-6300

Specialties & licenses 1

Addresses

Locations

Practitioners 101

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.

• Susan F Sirota, M.D.

  • Pediatrics Physician
  • Highland Park, IL
  • NPI 1396715595
  NPD (past) Authorized official
• Elizabeth Bail

  • Family Nurse Practitioner
  • Chicago, IL
  • NPI 1225503220
  NPD (past)
• Amee Elenore Bass, M.D.

  • Pediatrics Physician
  • Northbrook, IL
  • NPI 1316027634
  NPD (past)
• Paula Ann Bebej, DO

  • Pediatrics Physician
  • Schaumburg, IL
  • NPI 1881771459
  NPD (past)
• Rebecca Julia Bergman, M.D.

  • Pediatrics Physician
  • Lincolnshire, IL
  • NPI 1568567774
  NPD (past)
• Ronald Joseph Boduch, MD

  • Pediatric Adolescent Medicine Physician
  • Schaumburg, IL
  • NPI 1205832441
  NPD (past)
• Sarah Breen, D.O.

  • Pediatrics Physician
  • Buffalo Grove, IL
  • NPI 1972769586
  NPD (past)
• Brianne C Brown, FNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Vernon Hills, IL
  • NPI 1609303320
  NPD (past)
• Nancy Bunn Brown, M.D.

  • Pediatrics Physician
  • Gurnee, IL
  • NPI 1104052513
  NPD (past)
• Rebecca Cholst, M.D.

  • Pediatrics Physician
  • Chicago, IL
  • NPI 1316479421
  NPD (past)
• Darryl H. Colen, D.O.

  • Pediatrics Physician
  • Barrington, IL
  • NPI 1437136876
  NPD (past)
• Claire Creed, M.D.

  • Pediatrics Physician
  • Wheaton, IL
  • NPI 1215391107
  NPD (past)

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

{
    "created_epoch": "1351209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711065600000",
    "number": "1982958013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 WATERVIEW DR STE SM100",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600626145",
            "telephone_number": "224-330-6311",
            "fax_number": "224-330-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N WESTMORELAND RD",
            "address_2": "SUITE 217",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451674",
            "telephone_number": "847-615-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRUST, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-26",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A",
        "authorized_official_last_name": "SIROTA",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "224-330-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gopi R. Patel, D.O
• Shaily Patel
• Bryanna S Paunovich, MD
• Keely E Pedersen, PA-C
• Pamela Jean Pedersen, MS, APN, ACNS, CCRN
• Amar Jyothi Peruri, MD
• Dennis A Pessis, M.D.
• Samantha A Peter, APRN, CNP
• Michael Peters, MD
• Richard A. Phillips, MD

• Pediatrics Physician in Lake Forest, IL
• Providers in Lake Forest, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.