NPIMap

Pediatrust, L.L.C.

Organization Active NPI Pediatrics Physician · Lake Forest, IL

NPI 1982958013 · NPPES record last updated Mar 22, 2024

Key facts

NPI
1982958013
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 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
Organization subpart
No

Authorized official

Name
Dr. Susan Sirota, M.D. NPI 1396715595
Title
Ceo
Phone
(224) 330-6300

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 101

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

View all 101

National Provider Directory

Locations (25 of 33)

1640 W Lake St
Addison, IL 60101
Phone (630) 543-3020

1640 W Lake St
Fl 2
Addison, IL 60101
Phone (630) 543-3020

1640 W Lake St
Ste 200
Addison, IL 60101

1051 W Rand Rd
Ste 103
Arlington Hts, IL 60004
Phone (847) 259-5900

2101 Waukegan Rd
Ste 302
Bannockburn, IL 60015
Phone (847) 271-1512

2101 Waukegan Rd
Bannockburn, IL 60015
Phone (312) 923-1100

27750 W Il Route 22
Barrington, IL 60010
Phone (847) 381-4880

725 W Fabyan Pkwy
Unit B
Batavia, IL 60510
Phone (630) 690-7300

725 W Fabyan Pkwy
Batavia, IL 60510
Phone (630) 845-3366

260 E Congress Pkwy
Ste B
Crystal Lake, IL 60014

260 E Congress Pkwy
Crystal Lake, IL 60014
Phone (815) 477-0300

525 E Congress Pkwy
Ste 220
Crystal Lake, IL 60014
Phone (815) 459-6780

36100 N Brookside Dr
Ste 220
Gurnee, IL 60031

600 Central Ave
Highland Park, IL 60035
Phone (630) 933-4045

900 N Westmoreland Rd
Ste 217
Lake Forest, IL 60045
Phone (847) 482-0273

765 Ela Rd
Ste 102
Lake Zurich, IL 60047
Phone (847) 259-5070

1800 Hollister Dr
Libertyville, IL 60048
Phone (847) 672-6478

1800 Hollister Dr
Ste 200
Libertyville, IL 60048

1800 Hollister Dr
Ste 220
Libertyville, IL 60048
Phone (847) 362-5707

1800 Hollister Dr
Ste 202
Libertyville, IL 60048
Phone (847) 549-6473

185 Milwaukee Ave
Ste 220
Lincolnshire, IL 60069
Phone (847) 821-9500

185 Milwaukee Ave
Ste 230
Lincolnshire, IL 60069
Phone (847) 883-0077

2375 Waterview Dr
Ste N100
Northbrook, IL 60062

2215 Sanders Rd
Ste 105
Northbrook, IL 60062
Phone (224) 330-6300

2375 Waterview Dr
Ste SM100
Northbrook, IL 60062

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208000000X Yes

Addresses

Primary practice location

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

Mailing address

2375 Waterview Dr Ste Sm100
Northbrook, IL 60062-6145
Phone (224) 330-6311

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 22, 2024.

{
    "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

All providers in Lake Forest, IL · Pediatrics Physician in Illinois

Sources for this page

Verify at the official NPI Registry.