Healthcare Provider Details

I. General information

NPI: 1609822154
Provider Name (Legal Business Name): THE PULMONARY CLINIC FOR CHILDREN SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S WASHINGTON ST
NAPERVILLE IL
60540-7430
US

IV. Provider business mailing address

801 S WASHINGTON ST
NAPERVILLE IL
60540-7430
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-7325
  • Fax:
Mailing address:
  • Phone: 630-527-7325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number
License Number State

VIII. Authorized Official

Name: GIRISH SHARMA
Title or Position: OWNER / PHYSICIAN
Credential: MD
Phone: 630-527-7325