Healthcare Provider Details

I. General information

NPI: 1730334764
Provider Name (Legal Business Name): NEIGHBORHOOD PEDICATRICS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20200 GOVERNORS DR 101
OLYMPIA FIELDS IL
60461-1032
US

IV. Provider business mailing address

20200 GOVERNORS DR 101
OLYMPIA FIELDS IL
60461-1032
US

V. Phone/Fax

Practice location:
  • Phone: 708-481-5570
  • Fax:
Mailing address:
  • Phone: 708-481-5570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number036070219
License Number StateIL

VIII. Authorized Official

Name: DR. WILLIAM G KLIPFEL
Title or Position: OWNER/ PHYISICAN
Credential: MD
Phone: 708-481-5570