Organization
COMMUNITY PEDIATRICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHOK H BHASKAR MD (OWNER)
(815) 744-1600
Entity
Organization
Contact information
Practice address
16001 EXECUTIVE DR, CREST HILL, IL 60403-0500
(815) 744-1600
(815) 838-0556
Mailing address
16001 EXECUTIVE DR, CREST HILL, IL 60403-0500
(815) 744-1600
(815) 838-0556
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036093909
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10700025
—
IL
Enumeration date
03/03/2017
Last updated
03/03/2017
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