MEDICARE: GRACE PEDIATRICS LLC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801120860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE PEDIATRICS LLC

Provider Business Mailing Address
First Line	:	1118 BLOOMINGDALE RD
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-3498
Country	:	US
Telephone Number	:	630-784-8600
Fax Number	:	630-456-4086

Provider Business Practice Location Address
First Line	:	1118 BLOOMINGDALE RD
Second Line	:
City	:	GLENDALE HEIGHTS
State	:	IL
Zip	:	60139-3498
Country	:	US
Telephone Number	:	630-784-8600
Fax Number	:	630-456-4086

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. ARJUMAND FARHANA
Credential	:	M.D.
Telephone Number	:	312-933-8446

Provider Enumeration Date	:	09/23/2009
Last Update Date	:	07/21/2025

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Directions to “GRACE PEDIATRICS LLC ” Practice Location

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