Provider Demographics
NPI:1427094416
Name:SOUTHWEST PEDIATRICS, LTD.
Entity type:Organization
Organization Name:SOUTHWEST PEDIATRICS, LTD.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-361-3300
Mailing Address - Street 1:8100 W 119TH ST
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-3041
Mailing Address - Country:US
Mailing Address - Phone:708-361-3300
Mailing Address - Fax:708-361-8139
Practice Address - Street 1:8100 W 119TH ST
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-3041
Practice Address - Country:US
Practice Address - Phone:708-361-3300
Practice Address - Fax:708-361-8139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty