# CHILDREN'S CLINIC NETWORK

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Children's ENT and Facial Plastic Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275894982
- **Authorized official:** MARC H GORELICK MD (PRESIDENT & CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (612) 813-8031

## Contact information

- **Practice address:** 2525 CHICAGO AVENUE SOUTH, MINNEAPOLIS, MN 55404-4518
- **Practice address phone:** (612) 813-6000
- **Mailing address:** 5901 LINCOLN DRIVE, CBC-2-REV/PE, EDINA, MN 55436-1611
- **Mailing address phone:** (952) 992-5398
- **Mailing address fax:** (952) 992-6917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/30/2012
- **Last updated:** 10/31/2022