BACK TO BASICS PEDIATRICS SC (NPI# 1205310356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205310356 |
| Entity Type | Organization |
| Organization Name | BACK TO BASICS PEDIATRICS SC |
| Other Organization Name | BACK TO BASICS PEDIATRICS, S CORP |
| Practice Address |
2403 Harnish Dr Ste 101 Algonquin IL 60102-6803 |
| Practice Telephone | 2245200087 |
| Mailing Telephone | 2243330730 |
| Mailing Fax Number | 2243330748 |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2018-12-12 |
| Authorized Official Name | DR. CHRISTINE POULOS (PEDIATRICIAN) |
| Authorized Official Telephone | 2245200087 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Back to Basics Pediatrics, S Corp | Other Name - Individual/Organization |
| Street Address |
2403 HARNISH DR STE 101 |
| City | ALGONQUIN |
| State | IL |
| Zip Code | 60102-6803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679678874 | Christine M Poulos | Pediatrics | 2403 Harnish Dr Ste 101, Algonquin, IL 60102 | 2006-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700411329 | Amber Nicole Bianchi | Massage Therapist | 265 Stonegate Road, Algonquin, IL 60102 | 2020-03-04 |
| 1255971156 | Cler Family Solutions LLC | Case Management | 12 Waterfront Ct, Algonquin, IL 60102 | 2020-01-09 |
| 1114577079 | Camp Chirotherapy LLC | Chiropractor | 3925 W Algonquin Rd, Algonquin, ID 60102 | 2019-09-12 |
| 1295380392 | Kevin Layton Sanderson | In Home Supportive Care | 9604 Zimmer Drive, Algonquin, IL 60102 | 2019-08-06 |
| 1669964300 | Favia Primary Care, Sc | Family Medicine | 1340 Ryan Parkway, Algonquin, IL 60102 | 2018-05-30 |
| 1285142745 | Melissa Sue Aeschliman | Speech-Language Pathologist | 8 White Chapel Ct., Algonquin, IL 60102 | 2018-01-18 |
| 1295251940 | Maria Melina Dominguez | Counselor | 1138 N. Main Street, Algonquin, IL 60102 | 2017-08-15 |
| 1578001830 | Advanced Dental and Implant Care PC | Dentist | 2310 Huntington Dr. N., Algonquin, IL 60102 | 2017-02-07 |
| 1871037861 | Rehabcare Group East, LLC | Clinic/Center | 212 Eastgate Ct, Algonquin, IL 60102 | 2016-12-09 |
| 1891172664 | Foot and Ankle Specialists of Illinois Ltd | Podiatrist | 2430 Esplanade Drive Suite A, Algonquin, IL 60102 | 2015-04-30 |
| Find all providers in zip 60102 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679678874 | Christine M Poulos | Pediatrics | 2403 Harnish Dr Ste 101, Algonquin, IL 60102 | 2006-09-13 |
| 1043277148 | Richard Edward Powell | Pediatrics | Salud Pediatrics, 600 S. Randall Road Ste 220, Algonquin, IL 60102 | 2006-05-01 |
| 1205815545 | Neelam Narula | Pediatrics | 2971 W Algonquin Rd, Suite 105, Algonquin, IL 60102-9406 | 2006-01-14 |
| 1639458128 | Adrienne M. Edge | Pediatrics | 2971 W Algonquin Rd, Suite 105, Algonquin, IL 60102-9406 | 2011-08-15 |
| 1477717213 | Sandra Lukic Graba | Pediatrics | 600 S Randall Rd, Suite 220, Algonquin, IL 60102-5935 | 2008-07-10 |
| 1801968953 | Mussarat Arshad | Pediatrics | 2575 W Algonquin Rd, Suite A, Algonquin, IL 60102-9403 | 2006-11-14 |
| 1376648584 | Michael S Fell | Pediatrics | 620 S Main St, Algonquin, IL 60102-2752 | 2006-09-13 |
| 1518062736 | Joni Lynn M Hamilton | Pediatrics | 620 S Main St, Algonquin, IL 60102-2752 | 2006-09-13 |
| 1437254638 | June J Mannion | Pediatrics | 620 S Main St, Algonquin, IL 60102-2752 | 2006-09-13 |
| 1750486981 | Amr N Megahed | Pediatrics | 620 S Main St, Algonquin, IL 60102-2752 | 2006-09-13 |
| Find all providers in ALGONQUIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.