Healthcare Provider Details

I. General information

NPI: 1801120860
Provider Name (Legal Business Name): GRACE PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 BLOOMINGDALE RD
GLENDALE HEIGHTS IL
60139-3498
US

IV. Provider business mailing address

1118 BLOOMINGDALE RD
GLENDALE HEIGHTS IL
60139-3498
US

V. Phone/Fax

Practice location:
  • Phone: 630-784-8600
  • Fax: 630-456-4086
Mailing address:
  • Phone: 630-784-8600
  • Fax: 630-456-4086

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. ARJUMAND FARHANA
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 312-933-8446