Organization · NPI-2
Complete Child Health
Pediatrics, Adolescent Medicine · Bolingbrook, IL
NPI number1801108188
StatusActive
Last updated in NPPESJul 2, 2010
Details
- NPI
- 1801108188
- Entity type
- Organization (NPI-2)
- Legal business name
- Complete Child Health
- Organization subpart
- No
- Enumeration date
- Jul 2, 2010
- Last updated
- Jul 2, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080A0000X | Pediatrics, Adolescent Medicine | 036109931 | IL | Yes |
Practice location
498 W Boughton RdSuite 102
Bolingbrook, IL 60440-1893
Phone 630-771-1630 · Fax 630-771-1631
Mailing address
498 W Boughton RdSuite 102
Bolingbrook, IL 60440-1893
Phone 630-771-1630 · Fax 630-771-1631
Authorized official
Mohammad Mahmud Khan
Pediatrician
6307711630
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