EXCELSIOR MEDICAL CENTER LTD
NPI 1174709117
Pediatrics in Mundelein, IL
- Organization
- Pediatrics
- CLIA Number: 14D1075736
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 10-25-2027
About EXCELSIOR MEDICAL CENTER LTD
This page provides the complete NPI Profile along with additional information for Excelsior Medical Center Ltd, a pediatrician established in Mundelein, Illinois operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1174709117 assigned on January 2008. The practitioner's primary taxonomy code is 208000000X. The provider is registered as an organization and their NPI record was last updated 19 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Olga Ulyanova M.d. (Owner)
- NPI
- 1174709117 Verify this NPI
- Provider Name
- EXCELSIOR MEDICAL CENTER LTD
- Entity Type
- Organization
- Location Address
- 333 E IL ROUTE 83 SUITE 107 MUNDELEIN, IL 60060
- Location Phone
- (847) 566-5556
- Location Fax
- (847) 566-8886
- Mailing Address
- 333 E IL ROUTE 83 SUITE 107 MUNDELEIN, IL 60060
- Mailing Phone
- (847) 566-5556
- Mailing Fax
- (847) 566-8886
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-19-2008
- Last Update Date
- 01-19-2008
- Code Navigator
A pediatrician like Excelsior Medical Center Ltd is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics
- Taxonomy Code
- 208000000X
- Type
- Allopathic & Osteopathic Physicians
- License State
- IL
- Taxonomy Description
- 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.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D1075736
- Facility Type
- Physician Office
- Certificate Effective Date
- October 26, 2025
- Certificate Expiration Date
- October 25, 2027
- Laboratory Director
- OLGA ULYANOVA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Excelsior Medical Center Ltd to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
MUNDELEIN, IL 60060
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174709117, enumerated as an "organization" on January 19, 2008.
The provider is located at 333 E IL ROUTE 83 SUITE 107 MUNDELEIN, IL 60060 and the phone number is (847) 566-5556.
Pediatrics with taxonomy code 208000000X.
