Organization
PEDIATRIC PRACTICE ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMPRAKASH SAWLANI MD (PRESIDENT)
(630) 235-5000
Entity
Organization
Contact information
Practice address
7110 W 127TH ST, PALOS HEIGHTS, IL 60463-1571
(630) 235-5000
Mailing address
7110 W 127TH ST, PALOS HEIGHTS, IL 60463-1571
(630) 235-5000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057974
—
IL
Enumeration date
11/17/2017
Last updated
11/17/2017
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