Healthcare Provider Details

I. General information

NPI: 1932373107
Provider Name (Legal Business Name): MP PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 05/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5525 S PULASKI RD SUITE 2400
CHICAGO IL
60629-4417
US

IV. Provider business mailing address

5525 S PULASKI RD SUITE 2400
CHICAGO IL
60629-4417
US

V. Phone/Fax

Practice location:
  • Phone: 773-284-6270
  • Fax: 773-284-6290
Mailing address:
  • Phone: 773-284-6270
  • Fax: 773-284-6290

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER A PEREZ
Title or Position: PRESIDENT
Credential: MD
Phone: 773-284-6270