Healthcare Provider Details

I. General information

NPI: 1124134622
Provider Name (Legal Business Name): BISKUP & SEGUI PEDIATRIC PARTNERS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 09/17/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20325 S GRACELAND LN
FRANKFORT IL
60423-9047
US

IV. Provider business mailing address

20325 S GRACELAND LN
FRANKFORT IL
60423-9047
US

V. Phone/Fax

Practice location:
  • Phone: 815-469-8700
  • Fax:
Mailing address:
  • Phone: 815-469-8700
  • Fax:

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. NICOLE A BISKUP
Title or Position: PRESIDENT
Credential: M.D.
Phone: 815-469-8700