Organization
PARKSIDE PEDIATRICS, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA COTSIRILOS STEC MD (PRESIDENT)
(847) 823-8000
Entity
Organization
Contact information
Practice address
1875 DEMPSTER ST, SUITE 650, PARK RIDGE, IL 60068-1186
(847) 823-8000
Mailing address
1875 DEMPSTER ST, SUITE 650, PARK RIDGE, IL 60068-1186
(847) 823-8000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31601770
BLUE CROSS BLUE SHIELD IL
IL
01
—
L021602
TRICARE
IL
Enumeration date
04/05/2007
Last updated
08/22/2020
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