Provider Demographics
NPI:1588057277
Name:HAPPY KIDS PEDIATRIC GROUP INC
Entity type:Organization
Organization Name:HAPPY KIDS PEDIATRIC GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SREEMDEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAKRISHNAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-980-5520
Mailing Address - Street 1:1111 N PLAZA DR
Mailing Address - Street 2:SUITE # 310
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-6021
Mailing Address - Country:US
Mailing Address - Phone:815-980-5520
Mailing Address - Fax:
Practice Address - Street 1:901 CENTER ST
Practice Address - Street 2:SUITE 1001
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-2104
Practice Address - Country:US
Practice Address - Phone:847-429-1157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0369119461261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036119461Medicaid