Organization
OAK PARK PEDIATRICS LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIN TABACK M.D. (PRESIDENT)
(773) 209-5199
Entity
Organization
Contact information
Practice address
1107 CHICAGO AVE, OAK PARK, IL 60302-1803
(773) 209-5199
Mailing address
1125 N GROVE AVE, OAK PARK, IL 60302-1238
(773) 209-5199
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036-098343
IL
Other
Enumeration date
12/28/2010
Last updated
12/28/2010
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