CHILDREN'S PHYSICIAN GROUP NPI 1124362306

NPI Information

  • NPI: 1124362306
  • Provider Name: CHILDREN'S PHYSICIAN GROUP
  • Classification: Pediatrics - 2080P0202X
  • Specialization: Pediatric Cardiology
  • Entity Type: Organization
  • Doing Business As: CRYSTAL LAKE CLINIC
  • CLIA Number: 52D0661957
  • Address: 360 STATION DR
    CRYSTAL LAKE, IL
    ZIP 60014
  • Phone: (815) 338-6600

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NPI Details

CHILDREN'S PHYSICIAN GROUP is a pediatric cardiology pediatrics in Crystal Lake, IL. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. CHILDREN'S PHYSICIAN GROUP NPI is 1124362306. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Crystal Lake Clinic.

The provider's business location address is:

360 STATION DR
CRYSTAL LAKE, IL
ZIP 60014-978
Phone: (815) 338-6600
Fax: (815) 477-9826

The provider's authorized official is Smriti Khare .
The authorized official title is President, Children's Physician Grp and has the following contact phone number (414) 266-7615.

The CLIA number assigned to this NPI record is 52D0661957 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 11/12/2012 and was last updated on 11/12/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12080P0202XPediatricsPediatric CardiologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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