Healthcare Provider Details

I. General information

NPI: 1659880698
Provider Name (Legal Business Name): DR. KORDAS PEDIATRIC HEALTH CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2017
Last Update Date: 03/01/2023
Certification Date: 08/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3275 N ARLINGTON HEIGHTS RD STE 409
ARLINGTON HEIGHTS IL
60004-7709
US

IV. Provider business mailing address

3335 N ARLINGTON HEIGHTS RD STE H
ARLINGTON HEIGHTS IL
60004-1573
US

V. Phone/Fax

Practice location:
  • Phone: 224-857-8000
  • Fax: 244-857-8001
Mailing address:
  • Phone: 847-903-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036100837
License Number StateIL

VIII. Authorized Official

Name: BERNADETA KORDAS
Title or Position: SOLE MEMBER
Credential: MD
Phone: 847-903-5400