Organization
PEDIATRUST, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN SIROTA M.D. (CEO)
(224) 330-6300
Entity
Organization
Contact information
Practice address
900 N WESTMORELAND RD, SUITE 217, LAKE FOREST, IL 60045-1674
(847) 615-0700
Mailing address
2375 WATERVIEW DR STE SM100, NORTHBROOK, IL 60062-6145
(224) 330-6311
(224) 330-6325
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
10/26/2012
Last updated
03/22/2024
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