NPI 1982958013

Pediatrust, L.L.C.

Organisation Pediatrics Physician Lake Forest, IL

Practice location

Address: 900 N Westmoreland Rd Suite 217, Lake Forest, IL 60045-1674
Phone: (847) 615-0700
Mailing address: 2375 Waterview Dr STE Sm100, Northbrook, IL 60062-6145

Authorised official

Name: Susan Sirota
Title: Ceo
Phone: (224) 330-6300

Registered specialties

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X

Other Pediatrics providers in Illinois →

Registry record

NPI: 1982958013
Entity type: Organization
NPI issued: 26 Oct 2012
Record last updated: 22 Mar 2024

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.