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PEDIATRIC GROUP LLC
NPI 1023582038
Clinic/Center - Rural Health in Carbondale, IL

Active since January 14, 2019CLIA Certified · 4 labs
1175 CEDAR CT, CARBONDALE, IL 62901(618) 993-0404(618) 993-1717 Get Directions Write a Review

NPPES record last updated: April 29, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 29, 2026, May 15, 2025, Jan 14, 2019 (3 updates tracked since 2019).

About Pediatric Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC GROUP LLC (NPI 1023582038) is a healthcare organization registered as a rural health in Carbondale, Illinois and active in the NPI registry since January 2019. The organization holds 4 active CLIA laboratory certificates and lists Rhonda Lynn Fisher, Ceo, as its authorized official.

NPPES Registry Identity

NPI1023582038
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePEDIATRIC GROUP LLC
Location Address1175 CEDAR CTCarbondale, IL 62901-5333
Mailing Address3412 Office Park DrMarion, IL 62959-6477 · (618) 993-0404 · Fax (618) 993-1717
Phone(618) 993-0404
Fax(618) 993-1717
Organization SubpartYesParent: Pediatric Group, Llc
Authorized OfficialRhonda Lynn FisherCeo · (618) 993-0404
Enumeration DateJanuary 14, 2019
Last NPPES UpdateApril 29, 20263 updates tracked since enumeration
NPPES CertifiedApril 29, 2026
✔ NPI 1023582038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedPediatricsTaxonomy 208000000X
1175 CEDAR CT, Carbondale, IL 62901
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 5

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D0955814

Pediatric Group L L C · Marion, IL
Active · expires Jan 10, 2027
CLIA Number14D0955814
Laboratory TypePhysician Office
Certificate Effective DateJanuary 11, 2025
Certificate Expiration DateJanuary 10, 2027
Laboratory DirectorPradeep G. Reddy
Laboratory Phone(618) 993-0404
Laboratory LocationPediatric Group L L C3412 Office Park Drive, Marion, IL 62959
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D2005129

Pediatric Group L L C · Harrisburg, IL
Active · expires Mar 21, 2028
CLIA Number14D2005129
Laboratory TypePhysician Office
Certificate Effective DateMarch 22, 2026
Certificate Expiration DateMarch 21, 2028
Laboratory DirectorPradeep G. Reddy
Laboratory Phone(618) 993-0404
Laboratory LocationPediatric Group L L C28 Veterans Drive, Harrisburg, IL 62946
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D2005130

Pediatric Group L L C · West Frankfort, IL
Active · expires Mar 21, 2028
CLIA Number14D2005130
Laboratory TypePhysician Office
Certificate Effective DateMarch 22, 2026
Certificate Expiration DateMarch 21, 2028
Laboratory DirectorPradeep G. Reddy
Laboratory Phone(618) 993-0404
Laboratory LocationPediatric Group L L C310 W St Louis Street, West Frankfort, IL 62896
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D2177407

Pediatric Group, L L C · Centralia, IL
Active · expires Jan 8, 2028
CLIA Number14D2177407
Laboratory TypePhysician Office
Certificate Effective DateJanuary 9, 2026
Certificate Expiration DateJanuary 8, 2028
Laboratory DirectorPradeep G. Reddy M D
Laboratory Phone(618) 993-0404
Laboratory LocationPediatric Group, L L C130 S Lincoln Blvd, Centralia, IL 62801
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 14D2081463

Pediatric Group L L C · Carbondale, IL
Expired · Jul 24, 2026
CLIA Number14D2081463
Laboratory TypePhysician Office
Certificate Effective DateJuly 25, 2024
Certificate Expiration DateJuly 24, 2026
Laboratory DirectorPradeep Gopala Reddy
Laboratory Phone(618) 993-0404
Laboratory LocationPediatric Group L L C1175 N Cedar Ct, Carbondale, IL 62901
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MONICA L NAGELE NP
Nurse Practitioner (Psychiatric/Mental Health)
1175 CEDAR CT
CARBONDALE, IL 62901
Jackson County (618) 490-1045
REVIVE SKIN INSTITUTE LLC
Dermatology (Procedural Dermatology)
1175 CEDAR CT, CARBONDALE
CARBONDALE, IL 62901
Jackson County (619) 549-0300
MRS. BINDU REDDY M.D.
Pediatrics
1175 CEDAR CT
CARBONDALE, IL 62901
Jackson County (618) 993-0404
MUKESH CHAUDHRY M.D.
Family Medicine
1175 CEDAR CT
CARBONDALE, IL 62901
Jackson County (618) 549-0300
CARBONDALE FAMILY MEDICINE,LLC
Family Medicine
1175 CEDAR CT
CARBONDALE, IL 62901
Jackson County (618) 549-0300
DR. ANUP K CHAUDHRY M.D.
Dermatology
1175 CEDAR CT
CARBONDALE, IL 62901
Jackson County (618) 549-0300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric Group LLC's NPI number?

The NPI number for Pediatric Group LLC is 1023582038. It was assigned to this organization in the NPPES registry on January 14, 2019.

Where is Pediatric Group LLC located?

Pediatric Group LLC is located at 1175 Cedar Ct, Carbondale, IL 62901. The listed phone number is (618) 993-0404.

What is Pediatric Group LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Pediatric Group LLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Pediatric Group LLC was last updated on April 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.