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General NPI Number Information
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NPI Number | 1710103098
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Entity Type | Organization
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Legal Business Name | PACE PEDIATRICS, P.C.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 6341 KEOKUK RD
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City | INDIAN HEAD PARK
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State | IL
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Zip | 60525-4341
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Country | US
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Telephone | 708-790-4834
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Fax |
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Provider Business Mailing Address
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Address Line | 6341 KEOKUK RD
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City | INDIAN HEAD PARK
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State | IL
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Zip | 60525-4341
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Country | US
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Telephone | 708-790-4834
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTA L MURPHY
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Credential | M.S., OTR/L
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Telephone | 708-790-4834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 056004383
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License Number State | IL
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