Healthcare Provider Details

I. General information

NPI: 1629251194
Provider Name (Legal Business Name): HEALTHY STEPS PEDIATRICS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E CHICAGO ST
ELGIN IL
60120
US

IV. Provider business mailing address

204 GRANT VILLAGE
HINSDALE IL
60521
US

V. Phone/Fax

Practice location:
  • Phone: 847-531-8546
  • Fax: 847-531-8525
Mailing address:
  • Phone: 847-531-8546
  • Fax: 847-531-8525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number36076861
License Number StateIL

VIII. Authorized Official

Name: MARCO A GUERRA
Title or Position: PRESIDENT
Credential: MD
Phone: 847-531-8546