Provider Demographics
NPI:1366565756
Name:PEDIATRIC CENTRAL
Entity type:Organization
Organization Name:PEDIATRIC CENTRAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALHES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-359-9800
Mailing Address - Street 1:385 W NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-2414
Mailing Address - Country:US
Mailing Address - Phone:847-359-9800
Mailing Address - Fax:847-359-9899
Practice Address - Street 1:385 W NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-2414
Practice Address - Country:US
Practice Address - Phone:847-359-9800
Practice Address - Fax:847-359-9899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty