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Organization
SUBURBAN PEDIATRICS MEDICAL CENTER, LLC
Active
Organization
SUBURBAN PEDIATRICS MEDICAL CENTER, LLC
Active
Other names
Dr. Carletha Hughes
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLETHA CAROL HUGHES MD (OWNER)
(708) 754-3507
Entity
Organization
Contact information
Practice address
165 W 10TH ST, CHICAGO HEIGHTS, IL 60411-2000
(708) 754-3507
(708) 754-6153
Mailing address
3037 CARMEL DR, FLOSSMOOR, IL 60422-2263
(773) 983-3948
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036124598
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023249075
—
IL
Enumeration date
07/31/2017
Last updated
07/31/2017
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