Provider Demographics
NPI:1053434688
Name:PEDIATRIC HEALTH CARE ASSOCIATES, S.C.
Entity type:Organization
Organization Name:PEDIATRIC HEALTH CARE ASSOCIATES, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:ELCHANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-577-8272
Mailing Address - Street 1:1640 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-3985
Mailing Address - Country:US
Mailing Address - Phone:847-577-8272
Mailing Address - Fax:847-577-2149
Practice Address - Street 1:1640 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3985
Practice Address - Country:US
Practice Address - Phone:847-577-8272
Practice Address - Fax:847-577-2149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care