Mchenry Pediatrics Md Sc

LBN: Mchenry Pediatrics Md Sc
Mchenry Pediatrics Md Sc is an health care organization with primary practice located at 3625 Municipal Dr , Mchenry IL 60050-5434. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty. Mchenry Pediatrics Md Sc can be contacted via phone (815) 385-8560, or through Fasehun, Taiwo M via phone (815) 385-8560.

Contact Information

Primary practice address
3625 Municipal Dr Mchenry IL 60050-5434
Phone: (815) 385-8560
Fax: (815) 385-8568
Website:
Map and Directions
Authorized official contact:
Name: Fasehun, Taiwo M Doctor of Medicine (MD)
Phone: (815) 385-8560

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036087368 Illinois

Profile Details

NPI number 1013158468
LBN Legal business name Mchenry Pediatrics Md Sc
DBA Doing business as
Authorized official Fasehun, Taiwo M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 16th, 2009
Last updated Apr 29th, 2011 - about 15 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013158468 NPPES
Illinois MEDICAID 036087368
Illinois Other 05632223

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