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Organization

CHICAGO PEDIATRIC CLINIC CORP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DARLENE EGUES MD (PRESIDENT)
(773) 960-2555
Entity
Organization

Contact information

Practice address
1918 W IRVING PARK ROAD, CHICAGO, IL 60613
(773) 477-4900
(773) 477-4478
Mailing address
1918 W IRVING PARK ROAD, CHICAGO, IL 60613
(773) 477-4900
(773) 477-4478

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
11/29/2007
Last updated
11/29/2007
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  • EDI platform