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General NPI Number Information
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NPI Number | 1407194780
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Entity Type | Organization
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Legal Business Name | WELL BABY CARE PC
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Dates
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Enumeration Date | 01/22/2013
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 1185-87 DUNDEE AVENUE SUITE A-2
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City | ELGIN
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State | IL
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Zip | 60120
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Country | US
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Telephone | 847-608-9481
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Fax | 847-608-9483
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Provider Business Mailing Address
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Address Line | 1185-87 DUNDEE AVENUE SUITE A-2
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City | ELGIN
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State | IL
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Zip | 60120
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Country | US
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Telephone | 847-608-9481
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Fax | 847-608-9483
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Authorized Official
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Title or Position | PHYSICIAN, OWNER
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Name | SHARMITA A MISRA
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Credential | M.D.
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Telephone | 847-608-9481
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 036-085278
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036-085278
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License Number State | IL
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