Healthcare Provider Details

I. General information

NPI: 1669864815
Provider Name (Legal Business Name): PEARCE PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2015
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 SAUK TRL
RICHTON PARK IL
60471-1167
US

IV. Provider business mailing address

PO BOX 1033
YORKVILLE IL
60560-0896
US

V. Phone/Fax

Practice location:
  • Phone: 708-747-6000
  • Fax: 708-747-6003
Mailing address:
  • Phone: 630-385-2594
  • Fax: 630-385-2778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036104943
License Number StateIL

VIII. Authorized Official

Name: DR. FRANCINE PEARCE
Title or Position: MD
Credential: MD
Phone: 630-385-2594