LINCOLN PEDIATRIC CENTER PC NPI 1609836931

NPI Information

  • NPI: 1609836931
  • Provider Name: LINCOLN PEDIATRIC CENTER, PC
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 14D0994038
  • Address: 5641 N LINCOLN AVE
    CHICAGO, IL
    ZIP 60659
  • Phone: (773) 728-4784

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NPI Details

LINCOLN PEDIATRIC CENTER, PC is a pediatrics in Chicago, 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. LINCOLN PEDIATRIC CENTER, PC NPI is 1609836931. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5641 N LINCOLN AVE
CHICAGO, IL
ZIP 60659-921
Phone: (773) 728-4784
Fax: (773) 728-4759

The provider's authorized official is Joann Eviota Ruiz .
The authorized official title is Director and has the following contact phone number (773) 728-4784.

The CLIA number assigned to this NPI record is 14D0994038 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/23/2006 and was last updated on 10/26/2012.

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
1208000000XPediatrics036085554ILLINOISYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036085554MEDICAIDILLINOIS

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: 11/21/2025

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