Organization
PEDIATRIX MEDICAL GROUP OF ILLINOIS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARNOLD M POOLE (SIGNING AUTHORITY)
(954) 384-0175
Entity
Organization
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(815) 489-4177
(815) 490-5906
Mailing address
1500 CONCORD TER, SUNRISE, FL 33323-2815
(800) 243-3839
(844) 686-2961
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
Other
Enumeration date
09/17/2006
Last updated
02/01/2018
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