Provider Demographics
NPI:1285757245
Name:HINSDALE PEDIATRIC ASSOC.,S.C.
Entity type:Organization
Organization Name:HINSDALE PEDIATRIC ASSOC.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAFEESA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOOSABHOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-323-0890
Mailing Address - Street 1:911 N ELM ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3634
Mailing Address - Country:US
Mailing Address - Phone:630-323-0890
Mailing Address - Fax:630-323-9652
Practice Address - Street 1:911 N ELM ST
Practice Address - Street 2:SUITE 115
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3634
Practice Address - Country:US
Practice Address - Phone:630-323-0890
Practice Address - Fax:630-323-9652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative MedicineGroup - Single Specialty