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Organization

EDELSON PEDIATRICS SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL FREDERIC EDELSON MD (PEDIATRICIAN PRESIDENT)
(815) 588-3889
Entity
Organization

Contact information

Practice address
15750 S BELL RD STE 2A, HOMER GLEN, IL 60491-8420
(708) 301-6004
Mailing address
15750 S BELL RD STE 2A, HOMER GLEN, IL 60491-8420
(708) 301-6004

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G19148
IL
Enumeration date
01/24/2007
Last updated
02/04/2008
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