A TO Z PEDIATRIC AND YOUTH HEALTHCARE NPI 1962728386

NPI Information

NPI: 1962728386
Provider Name: A TO Z PEDIATRIC AND YOUTH HEALTHCARE

Former Legal Business Name: WALTER D PEREZ MD SC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
721 W LAKE ST
SUITE 202
ADDISON, IL
ZIP 60101
Phone: (630) 757-4010
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A TO Z PEDIATRIC AND YOUTH HEALTHCARE is a primary care clinic center in Addison, IL. A TO Z PEDIATRIC AND YOUTH HEALTHCARE NPI is 1962728386. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Walter D Perez Md Sc.

The provider's business location address is:

721 W LAKE ST
SUITE 202
ADDISON, IL
ZIP 60101-035
Phone: (630) 757-4010
Fax: (630) 757-4011

The provider's authorized official is Walter D Perez .
The authorized official title is President and has the following contact phone number (630) 757-4010.

The enumeration date for this NPI number is 4/9/2010 and was last updated on 2/16/2011.

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
1	261QP2300X	Clinic/Center	Primary Care	042619155	ILLINOIS	No
2	261QP2300X	Clinic/Center	Primary Care	036-097752	ILLINOIS	Yes

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
1	03-6097752	MEDICAID	ILLINOIS

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

NPI Synchronization or Removal

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