Healthcare Provider Details
I. General information
NPI: 1447453717
Provider Name (Legal Business Name): OAK-MILL PEDIATRICS S.C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2007
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 N MILWAUKEE AVE STE 2-26
NILES IL
60714-3159
US
IV. Provider business mailing address
7900 N MILWAUKEE AVE STE 2-26
NILES IL
60714-3159
US
V. Phone/Fax
- Phone: 847-581-1030
- Fax: 847-581-1441
- Phone: 847-581-1030
- Fax: 847-581-1441
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080A0000X |
| Taxonomy | Pediatric Adolescent Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ELZBIETA
LOJEWSKI
Title or Position: PRESIDENT
Credential: MD
Phone: 847-581-1030