MEDICARE: KIDS FIRST PEDIATRICS, LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	55361293	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1417047598	OTHER	IL	NPID

General Provider Information

NPI Number	:	1417047598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIDS FIRST PEDIATRICS, LTD

Provider Business Mailing Address
First Line	:	24600 W 127TH ST
Second Line	:	BUILDING B, SUITE 345
City	:	PLAINFIELD
State	:	IL
Zip	:	60585-9502
Country	:	US
Telephone Number	:	815-609-5437
Fax Number	:	815-609-8111

Provider Business Practice Location Address
First Line	:	24600 W 127TH ST
Second Line	:	BUILDING B, SUITE 345
City	:	PLAINFIELD
State	:	IL
Zip	:	60585-9502
Country	:	US
Telephone Number	:	815-609-5437
Fax Number	:	815-609-8111

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. STEVEN KOVAR
Credential	:	M.D.
Telephone Number	:	815-609-5437

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	05/04/2012

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