Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric Specialist of the NW Mdsc

Organization Pediatrics Physician · NPI 1598765521

Pediatric Specialist of the NW Mdsc is a Pediatrics Physician in Crystal Lake, Illinois. Licensed in Illinois. Registered with an NPI since 2005.

Licensed in
IL
In the registry since
2005

Practice location Address checks out

475 W Terra Cotta Ave Ste 01
Crystal Lake, IL 60014-3407
Phone: (847) 381-5005
Fax: (847) 381-5036
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X (IL)

Record details

NPI number1598765521
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Charles Braverman — Authorized Official · (843) 381-5005
NPI enumeratedAugust 1, 2005
Last updated in NPPESJuly 21, 2022
Mailing address5057 Shoreline Rd, Lake Barrington, IL 60010-1700

Other providers in Crystal Lake