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Organization

ALL BEAR CUB PEDIATRICS, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEISHA ROLLS (ACCT MANAGER)
(630) 384-1254
Entity
Organization

Contact information

Practice address
473 W ARMY TRAIL ROAD, SUITE 102, BLOOMINGDALE, IL 60108-2674
(630) 529-1000
(630) 529-7497
Mailing address
473 W ARMY TRAIL ROAD, #102, BLOOMINGDALE, IL 60108
(630) 529-6969
(630) 529-7497

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036051771
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-051771
IL
Enumeration date
12/05/2006
Last updated
08/04/2010
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