Healthcare Provider Details

I. General information

NPI: 1609602937
Provider Name (Legal Business Name): INSIGHTFUL PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 W CARMEL DR STE 203
CARMEL IN
46032-5875
US

IV. Provider business mailing address

11519 WILLOW BEND DR
ZIONSVILLE IN
46077-7717
US

V. Phone/Fax

Practice location:
  • Phone: 847-903-8958
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICOLE MOLINARO
Title or Position: CO- OWNER
Credential:
Phone: 847-903-8958