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General NPI Number Information
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NPI Number | 1356205538
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Entity Type | Organization
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Legal Business Name | CHICAGO DEVELOPMENTAL & BEHAVIORAL PEDIATRICS, PC
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 2123 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-3923
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Country | US
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Telephone | 773-636-6975
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Fax |
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Provider Business Mailing Address
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Address Line | 4132 N BELL AVE
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City | CHICAGO
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State | IL
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Zip | 60618-2914
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KARIN VANDER PLOEG BOOTH
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Credential | MD
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Telephone | 773-636-6975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0006X
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Taxonomy Name | Developmental - Behavioral Pediatrics Physician
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License Number |
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License Number State |
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