Back to Basics Pediatrics SC

Pediatrics Physician · Algonquin, IL

Organization Active NPI

NPI number 1205310356

Practice location

2403 Harnish Dr Ste 101
Algonquin, IL 60102-6803
Phone
(224) 520-0087

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NPI record

NPI
1205310356
Entity type
Organization (Type 2)
Enumeration date
September 24, 2018
Last updated
December 12, 2018
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Pediatrics Physician Primary 208000000X — —

Authorized official

Name
Dr. Christine Poulos, MD
Title
Pediatrician
Phone
(224) 520-0087

Other names

  • Back to Basics Pediatrics, S Corp
  • Back to Basics Pediatrics, S Corp

About Back to Basics Pediatrics SC

Back to Basics Pediatrics SC is a healthcare organization registered in the NPI registry with the primary taxonomy Pediatrics Physician (code 208000000X). The practice location is 2403 Harnish Dr Ste 101, Algonquin, IL 60102-6803. The NPI number 1205310356 was assigned on September 24, 2018 and the record was last updated on December 12, 2018.

The authorized official for this organization is Dr. Christine Poulos, MD, Pediatrician.

Frequently asked questions

What is the NPI number of Back to Basics Pediatrics SC?

The NPI number is 1205310356.

What is the phone number of Back to Basics Pediatrics SC?

The phone number listed for the practice location is (224) 520-0087.

Where is Back to Basics Pediatrics SC located?

2403 Harnish Dr Ste 101, Algonquin, IL 60102-6803.

What is the taxonomy code for Back to Basics Pediatrics SC?

The primary taxonomy code is 208000000X – Pediatrics Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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