Organization
SUBURBAN PEDIATRICS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA JEAN WAGNER (OFFICE MANAGER)
(847) 296-1177
Entity
Organization
Contact information
Practice address
9000 WAUKEGAN RD STE 240, MORTON GROVE, IL 60053-2128
(847) 296-1177
(847) 296-6437
Mailing address
9000 WAUKEGAN RD STE 240, MORTON GROVE, IL 60053-2128
(847) 296-1177
(847) 296-6435
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042-000280
IL
Other
Enumeration date
07/31/2006
Last updated
04/22/2022
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