BACK TO BASICS PEDIATRICS SC NPI 1205310356

NPI Details

BACK TO BASICS PEDIATRICS SC is a pediatrics in Algonquin, IL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. BACK TO BASICS PEDIATRICS SC NPI is 1205310356. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Back To Basics Pediatrics, S Corp.

The provider's business location address is:

2403 HARNISH DR STE 101
ALGONQUIN, IL
ZIP 60102-803
Phone: (224) 520-0087

The provider's authorized official is Christine Poulos .
The authorized official title is Pediatrician and has the following contact phone number (224) 520-0087.

The CLIA number assigned to this NPI record is 14D2156257 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/24/2018 and was last updated on 12/12/2018.

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: