Provider Demographics
NPI:1285741165
Name:CHILDRENS MEDICAL ASSOCIATES,LTD.
Entity type:Organization
Organization Name:CHILDRENS MEDICAL ASSOCIATES,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:QUAAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-236-6336
Mailing Address - Street 1:4550 MEMORIAL DR STE 260
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62226-5359
Mailing Address - Country:US
Mailing Address - Phone:618-236-6336
Mailing Address - Fax:618-236-9582
Practice Address - Street 1:4550 MEMORIAL DR STE 260
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62226-5359
Practice Address - Country:US
Practice Address - Phone:618-236-6336
Practice Address - Fax:618-236-9582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty