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PEDIATRIC GROUP, LLC
NPI 1487290615
Pediatrics in Centralia, IL

Active since November 22, 2019
130 S LINCOLN BLVD, CENTRALIA, IL 62801(618) 993-0404(618) 993-1717 Get Directions Write a Review

NPPES record last updated: October 23, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 23, 2023, Nov 22, 2019 (2 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 1487290615) is a healthcare organization registered as a pediatrics in Centralia, Illinois and active in the NPI registry since November 2019. The organization lists Rhonda Lynn Fisher, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1487290615
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDIATRIC GROUP, LLC
Location Address130 S LINCOLN BLVDCentralia, IL 62801-3654
Mailing Address3412 Office Park DrMarion, IL 62959-6477 · (618) 993-0404 · Fax (618) 993-1717
Phone(618) 993-0404
Fax(618) 993-1717
Organization SubpartYes
Authorized OfficialRhonda Lynn FisherOffice Manager · (618) 993-0404
Enumeration DateNovember 22, 2019
Last NPPES UpdateOctober 23, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 29, 2023
✔ NPI 1487290615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
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.
130 S LINCOLN BLVD, Centralia, IL 62801
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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

Other Providers at the Same Location NPPES

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

DR. MATTHEW TOLMAN STEDELIN M.D.
Pediatrics
130 S LINCOLN BLVD
CENTRALIA, IL 62801
Marion County (618) 532-3604

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 1487290615. It was assigned to this organization in the NPPES registry on November 22, 2019.

Where is Pediatric Group, LLC located?

Pediatric Group, LLC is located at 130 S Lincoln Blvd, Centralia, IL 62801. The listed phone number is (618) 993-0404.

What is Pediatric Group, LLC's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

When was this NPI record last updated?

The NPPES record for Pediatric Group, LLC was last updated on October 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.