# CHILDRENS ILLINOIS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073283198
- **Authorized official:** MICHELE MCKEE (VICE PRESIDENT)
- **Authorized official phone:** (314) 454-6044

## Contact information

- **Practice address:** 2122 TROY RD STE 120, EDWARDSVILLE, IL 62025-2540
- **Practice address phone:** (618) 800-4620
- **Mailing address:** 1 CHILDRENS PL STE 3S-36, SAINT LOUIS, MO 63110-1002

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | — | NULL | — |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | — | — | — |
| 261QH0700X | Hearing and Speech Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | — | NULL | — |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 09/20/2021
- **Last updated:** 09/23/2021