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General NPI Number Information
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NPI Number | 1720276553
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Entity Type | Organization
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Legal Business Name | INFANTS & CHILDRENS CLINIC
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 901 BIESTERFIELD RD SUITE 200
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-3392
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Country | US
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Telephone | 847-357-8714
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Fax | 847-357-8719
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Provider Business Mailing Address
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Address Line | 901 BIESTERFIELD RD SUITE 200
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-3392
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Country | US
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Telephone | 847-357-8714
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Fax | 847-357-8719
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MALGORZATA MARIA PATEREK
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Credential | M.D.
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Telephone | 847-357-8714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0
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License Number State | IL
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