Unknown Individual – Pediatrics Physician, NPI 1629051289
Pediatrics Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1262-1264, West Early Avenue, Magnolia Glen, Edgewater, Chicago, Lake View Township, Cook County, Illinois, 60660, United States
CHICAGO, IL 606603480
Phone: (404) 877-2902
Type: Mailing
West Taylor Street, Near West Side, University Village/Little Italy, Chicago, Cook County, Illinois, 60607, United States
CHICAGO, IL 606124795
Phone: (312) 996-7416
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 60660)
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