Provider Demographics
NPI:1316341720
Name:MD PEDIATRIC CENTER
Entity type:Organization
Organization Name:MD PEDIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OMPRAKASH
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWLANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-235-5000
Mailing Address - Street 1:4400 W 95TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2654
Mailing Address - Country:US
Mailing Address - Phone:708-425-2880
Mailing Address - Fax:708-425-0609
Practice Address - Street 1:4400 W 95TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2654
Practice Address - Country:US
Practice Address - Phone:708-425-2880
Practice Address - Fax:708-425-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-14
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty