NPI 1295822120

Bloomingdale General Pediatrics

Organisation Pediatrics Physician Bloomingdale, IL

Practice location

Address: 109 Fairfield Way Suite 103, Bloomingdale, IL 60108-1583
Phone: (630) 894-3250
Fax: (630) 894-3280

Authorised official

Name: Edwin Pascual
Title: President
Phone: (630) 894-3250

Registered specialties

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 036067770 (IL)

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Registry record

NPI: 1295822120
Entity type: Organization
NPI issued: 10 Oct 2006
Record last updated: 20 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.