| Grace Pediatrics Llc | |
|
1118 Bloomingdale Rd Glendale Heights IL 60139-3498 | |
| (630) 784-8600 | |
| (630) 456-4086 |
| Full Name | Grace Pediatrics Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1118 Bloomingdale Rd, Glendale Heights, Illinois |
| Authorized Official Name and Position | Arjumand Farhana (PHYSICIAN) |
| Authorized Official Contact | 3129338446 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Pediatrics Llc Po Box 5005 Glendale Heights IL 60139-5005 Ph: (630) 784-8600 | Grace Pediatrics Llc 1118 Bloomingdale Rd Glendale Heights IL 60139-3498 Ph: (630) 784-8600 |
| NPI Number | 1801120860 |
|---|---|
| Provider Enumeration Date | 09/23/2009 |
| Last Update Date | 03/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801120860 | NPI | - | NPPES |
| 36106640 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036106640 (Illinois) | Primary |
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