Innovative Pediatrics Llc
LBN: Innovative Pediatrics Llc
Innovative Pediatrics Llc is an health care organization with primary practice located at 1048 W Lawrence Ave #1, Chicago IL 60640-6544. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as the primary health care specialty.
Innovative Pediatrics Llc can be contacted via phone (773) 968-7871, or through Mattson, Bryan David via phone (773) 968-7871.
Contact Information
Primary practice address
1048 W Lawrence Ave #1
Chicago IL 60640-6544
Phone: (773) 968-7871
Fax: (773) 561-6815
Website:
Authorized official contact:
Name: Mattson, Bryan David Registered Occupational Therapist (OTR)
Phone: (773) 968-7871
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | Illinois |
Profile Details
| NPI number | 1841336922 |
|---|---|
| LBN Legal business name | Innovative Pediatrics Llc |
| DBA Doing business as | |
| Authorized official | Mattson, Bryan David Registered Occupational Therapist (OTR) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Feb 6th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841336922 | NPPES |
| Illinois | Other | 01628182 | IL BLUE CROSS PROVIDER # |
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