Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Edgemont Pediatrics, PC

Organization Pediatrics Physician · NPI 1689825838

Edgemont Pediatrics, PC provides Pediatrics Physician services in East Saint Louis, Illinois. Licensed in Illinois. Registered with an NPI since 2008.

Licensed in
IL
In the registry since
2008
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

8710 State St
East Saint Louis, IL 62203-2048 Not confirmed with CMS for 18 years — call before visiting
Phone: (618) 398-6601
Fax: (618) 398-4525
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 036085372 (IL)

Record details

NPI number1689825838
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Justin Ogbevoen — Ceo · (618) 398-6601
NPI enumeratedOctober 7, 2008
Last updated in NPPESOctober 7, 2008
Mailing address8710 State St, East Saint Louis, IL 62203-2048

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