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Organization
CHILDRENS MEDICAL CENTER SC
Active
Organization
CHILDRENS MEDICAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NADA AL DALLAL M.D. (PRESIDENT)
(773) 847-9004
Entity
Organization
Contact information
Practice address
1801 W 47TH ST, CHICAGO, IL 60609-3872
(773) 847-9004
(773) 847-9008
Mailing address
1801 W 47TH ST, CHICAGO, IL 60609-3872
(773) 847-9004
(773) 847-9008
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
IL
2080P0214X
Pediatric Pulmonology Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001636919
BLUE CROSS BLUE SHIELD
IL
Enumeration date
01/09/2007
Last updated
09/11/2025
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