Pediatric Fundamentals,llc - Speech-Language Pathologist in Custer Park, IL

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Pediatric Fundamentals,llc is a Speech-language Pathologist based in Custer Park, Illinois. Pediatric Fundamentals,llc is licensed to practice in Illinois (license number 146006731) and their current practice location is 36963 Irish Ln, Custer Park, Illinois. It can be reached at their office (for appointments etc.) via phone at (815) 931-8595.

NPI number for Pediatric Fundamentals,llc is 1396155156 and their current mailing address is 36963 Irish Ln, Custer Park, Illinois. Pediatric Fundamentals,llc does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1396155156.

Contact Information

Pediatric Fundamentals,llc
36963 Irish Ln,
Custer Park, IL 60481-8420
(815) 931-8595
Not Available

Map and Direction




Healthcare Provider's Profile

Full NamePediatric Fundamentals,llc
TypeFacility
SpecialitySpeech-language Pathologist
Location36963 Irish Ln, Custer Park, Illinois
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1396155156
  • Provider Enumeration Date: 05/02/2014
  • Last Update Date: 05/02/2014

Medical Identifiers

Medical identifiers for Pediatric Fundamentals,llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396155156NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
235Z00000XSpeech-language Pathologist 146006731 (Illinois)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Pediatric Fundamentals,llc is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Pediatric Fundamentals,llc
36963 Irish Ln,
Custer Park, IL 60481-8420

Ph: () -		Pediatric Fundamentals,llc
36963 Irish Ln,
Custer Park, IL 60481-8420

Ph: (815) 931-8595

Reviews and Comments


Speech-Language Pathologist in Custer Park, IL


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