Healthcare Provider Details

I. General information

NPI: 1124952684
Provider Name (Legal Business Name): THRIVE PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 KESLINGER RD STE 130
GENEVA IL
60134-3751
US

IV. Provider business mailing address

2800 KESLINGER RD STE 130
GENEVA IL
60134-3751
US

V. Phone/Fax

Practice location:
  • Phone: 847-531-4883
  • Fax:
Mailing address:
  • Phone: 847-531-4883
  • 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: DEANNE MILLER
Title or Position: OWNER
Credential:
Phone: 847-531-4883