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General NPI Number Information
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NPI Number | 1306050943
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Entity Type | Organization
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Legal Business Name | HIGHLAND PARK PEDIATRIC ASSOCIATES
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 1160 PARK AVE W SUITE 3E
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-2230
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Country | US
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Telephone | 847-432-8422
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Fax | 847-432-9480
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Provider Business Mailing Address
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Address Line | 1160 PARK AVE W SUITE 3E
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-2230
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Country | US
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Telephone | 847-432-8422
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Fax | 847-432-9480
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Authorized Official
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Title or Position | BOOKKEEPING RECEPTION
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Name | LESLIE G LEVIN
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Credential |
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Telephone | 847-432-8422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080H0002X
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Taxonomy Name | Pediatric Hospice and Palliative Medicine Physician
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License Number |
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License Number State |
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