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General NPI Number Information
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NPI Number | 1932373107
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Entity Type | Organization
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Legal Business Name | MP PEDIATRICS
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 5525 S PULASKI RD SUITE 2400
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City | CHICAGO
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State | IL
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Zip | 60629-4417
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Country | US
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Telephone | 773-284-6270
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Fax | 773-284-6290
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Provider Business Mailing Address
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Address Line | 5525 S PULASKI RD SUITE 2400
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City | CHICAGO
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State | IL
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Zip | 60629-4417
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Country | US
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Telephone | 773-284-6270
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Fax | 773-284-6290
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JENNIFER A PEREZ
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Credential | MD
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Telephone | 773-284-6270
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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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