Organization
SUNSHINE PEDIATRICS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM UTLEY M.D. (PRESIDENT)
(847) 587-9090
Entity
Organization
Contact information
Practice address
214 WASHINGTON ST, STE 3, INGLESIDE, IL 60041-9208
(847) 587-9090
(847) 587-9093
Mailing address
214 WASHINGTON ST, STE 3, INGLESIDE, IL 60041-9208
(847) 587-9090
(847) 587-9093
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036108990
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932453
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/16/2006
Last updated
02/17/2010
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