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General NPI Number Information
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NPI Number | 1821126731
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Entity Type | Organization
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Legal Business Name | STRATFORD PEDIATRICS ASSOCIATES, LTD
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 231 S GARY AVE STE 108
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2227
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Country | US
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Telephone | 630-893-3953
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Fax | 630-893-9570
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Provider Business Mailing Address
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Address Line | 231 S GARY AVE STE 108
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2227
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Country | US
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Telephone | 630-893-3953
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Fax | 630-893-9570
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Authorized Official
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Title or Position | PRESIDENT
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Name | VICTOR JAY ZUCKERMAN
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Credential | D.O.
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Telephone | 630-893-3953
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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 |
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License Number State |
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