Genesis Pediatric Medicine, LLC

NPI #1912295494 in Sycamore, Illinois

Provider Information

NPI Number: 1912295494
Entity Type: Organization
Organization Name: Genesis Pediatric Medicine, LLC
Primary Specialty: Pediatrics
Enumeration Date: Jul 18, 2011
Last Updated: Jul 18, 2011

Practice Location

Address: 1830 MEDITERRANEAN DR
City: Sycamore
State: Illinois
ZIP Code: 60178-3144
Phone: (815) 899-0001

Authorized Official

Name: DR. MARK ALAN REGNIER, M.D.
Title: PRESIDENT
Phone: (815) 899-0001

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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