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Organization
PEDIATRIC GROUP LLC
Active
Organization
PEDIATRIC GROUP LLC
Active
Parent organization
PEDIATRIC GROUP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC GROUP, LLC
Authorized official
RHONDA LYNN FISHER (CEO)
(618) 993-0404
Entity
Organization
Contact information
Practice address
1175 CEDAR CT, CARBONDALE, IL 62901-5333
(618) 993-0404
(618) 993-1717
Mailing address
3412 OFFICE PARK DR, MARION, IL 62959-6477
(618) 993-0404
(618) 993-1717
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NULL
208000000X
Pediatrics Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
01/14/2019
Last updated
10/07/2026
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