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PEDIATRICS AND CHILD DEVELOPMENT CLINIC INC. NPI 1265440663


NPI Information

NPI: 1265440663
Provider Name: PEDIATRICS AND CHILD DEVELOPMENT CLINIC INC.
Classification: Pediatrics - 2080P0006X
Entity Type: Organization

Specialization: Developmental - Behavioral Pediatrics

CLIA Number: 14D1008196

Address:
2575 W ALGONQUIN RD
SUITE A
ALGONQUIN, IL
ZIP 60102
Phone: (847) 658-4574
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PEDIATRICS AND CHILD DEVELOPMENT CLINIC INC. is a developmental - behavioral pediatrics pediatrics in Algonquin, IL. The provider is a developmental-behavioral specialist is a pediatrician with special training and experience who aims to foster understanding and promotion of optimal development of children and families through research, education, clinical care and advocacy efforts. This physician assists in the prevention, diagnosis, and management of developmental difficulties and problematic behaviors in children and in the family dysfunctions that compromise children's development. PEDIATRICS AND CHILD DEVELOPMENT CLINIC INC. NPI is 1265440663. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2575 W ALGONQUIN RD
SUITE A
ALGONQUIN, IL
ZIP 60102-403
Phone: (847) 658-4574
Fax: (847) 587-6113

The provider's authorized official is Mussarat Arshad .
The authorized official title is Owner and has the following contact phone number (847) 658-4574.

The CLIA number assigned to this NPI record is 14D1008196 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/3/2006 and was last updated on 11/17/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12080P0008XPediatricsNeurodevelopmental Disabilities036092453ILLINOISNo
22080P0006XPediatricsDevelopmental - Behavioral Pediatrics036092453ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1036092453MEDICAIDILLINOIS
2201116MEDICARE PINILLINOIS
305628082OTHERILLINOISBLUE CROSS/SHIELD

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: 11/14/2023

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