Healthcare Provider Details

I. General information

NPI: 1376912246
Provider Name (Legal Business Name): RAPPAPORT PEDIATRICS, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2015
Last Update Date: 09/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 LINCOLN AVE SUITE1
WINNETKA IL
60093-2355
US

IV. Provider business mailing address

570 LINCOLN AVE SUITE1
WINNETKA IL
60093-2355
US

V. Phone/Fax

Practice location:
  • Phone: 224-255-6001
  • Fax: 224-255-6709
Mailing address:
  • Phone: 224-255-6001
  • Fax: 224-255-6709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JESSICA RAPPAPORT
Title or Position: OWNER
Credential: M.D.
Phone: 224-255-6001