Organization
SALUD PEDIATRICS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANNA E. BETANCOURT M.D. (DIRECTOR)
(847) 854-9402
Entity
Organization
Contact information
Practice address
600 S RANDALL RD, SUITE 220, ALGONQUIN, IL 60102-5935
(847) 854-9402
(847) 854-9403
Mailing address
600 S RANDALL RD, SUITE 220, ALGONQUIN, IL 60102-5935
(847) 854-9402
(847) 854-9403
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036101829
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05632081
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
07/13/2006
Last updated
04/06/2011
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