# PEDIATRIC GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PEDIATRIC GROUP, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1023582038
- **Legal business name:** PEDIATRIC GROUP, LLC
- **Authorized official:** RHONDA LYNN FISHER (CEO)
- **Authorized official phone:** (618) 993-0404

## Contact information

- **Practice address:** 1175 CEDAR CT, CARBONDALE, IL 62901-5333
- **Practice address phone:** (618) 993-0404
- **Practice address fax:** (618) 993-1717
- **Mailing address:** 3412 OFFICE PARK DR, MARION, IL 62959-6477
- **Mailing address phone:** (618) 993-0404
- **Mailing address fax:** (618) 993-1717

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 01/14/2019
- **Last updated:** 10/07/2026