Organization
CENTER FOR AUTONOMIC MEDICINE IN PEDIATRICS
Active
Parent organization
PEDIATRIC FACULTY FOUNDATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC FACULTY FOUNDATION
Authorized official
LISA LENZ (DIRECTOR)
(312) 573-4515
Entity
Organization
Contact information
Practice address
2300 N CHILDRENS PLZ # 64, CHICAGO, IL 60614-3363
(312) 573-4515
(312) 573-8405
Mailing address
2300 N CHILDRENS PLZ # 64, CHICAGO, IL 60614-3363
(312) 573-4515
(312) 573-8405
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Enumeration date
01/14/2008
Last updated
01/14/2008
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