Healthcare Provider Details

I. General information

NPI: 1972199479
Provider Name (Legal Business Name): THRIVE PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 ALFT LN STE 100
ELGIN IL
60124-8090
US

IV. Provider business mailing address

2410 ALFT LN STE 100
ELGIN IL
60124-8090
US

V. Phone/Fax

Practice location:
  • Phone: 847-531-4883
  • Fax:
Mailing address:
  • Phone: 847-531-4883
  • Fax: 847-478-3229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DEANNE MILLER
Title or Position: OWNER
Credential:
Phone: 847-531-4883