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Organization

ILLINI PEDIATRICS, LLC

Active
Other names
Ideal Pediatrics
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH E CANGAS M.D. (MANAGING MEMBER)
(618) 281-4325
Entity
Organization

Contact information

Practice address
1550 N MAIN ST STE E, COLUMBIA, IL 62236
(618) 281-4325
(618) 208-1313
Mailing address
1550 N MAIN ST STE E, COLUMBIA, IL 62236-1070
(618) 281-4325
(618) 208-1313

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036110913
IL

Other

Enumeration date
04/28/2006
Last updated
03/12/2019
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