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Organization
BLOOMINGDALE GENERAL PEDIATRICS
Active
Organization
BLOOMINGDALE GENERAL PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN PASCUAL M.D (PRESIDENT)
(630) 894-3250
Entity
Organization
Contact information
Practice address
109 FAIRFIELD WAY, SUITE 103, BLOOMINGDALE, IL 60108-1583
(630) 894-3250
(630) 894-3280
Mailing address
109 FAIRFIELD WAY, SUITE 103, BLOOMINGDALE, IL 60108-1583
(630) 894-3250
(630) 894-3280
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036067770
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002201004
BCBS
IL
05
—
036067770
—
IL
05
—
036083477
—
IL
Enumeration date
10/10/2006
Last updated
05/20/2008
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