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GENESIS PEDIATRIC MEDICINE, LLC
NPI 1912295494
Pediatrics in Sycamore, IL

Active since July 18, 2011CLIA 14D2037551 · Waiver
1830 MEDITERRANEAN DR, SYCAMORE, IL 60178(815) 899-0001(815) 899-0002 Get Directions Write a Review

NPPES record last updated: July 18, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Genesis Pediatric Medicine, Llc NPPES

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

GENESIS PEDIATRIC MEDICINE, LLC (NPI 1912295494) is a healthcare organization registered as a pediatrics in Sycamore, Illinois and active in the NPI registry since July 2011. The organization holds a CLIA Waiver certificate valid through February 29, 2028 and lists Mark Alan Regnier, President, as its authorized official.

NPPES Registry Identity

NPI1912295494
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameGENESIS PEDIATRIC MEDICINE, LLC
Location Address1830 MEDITERRANEAN DRSycamore, IL 60178-3144
Mailing Address1830 Mediterranean DrSycamore, IL 60178-3144 · (815) 899-0001 · Fax (815) 899-0002
Phone(815) 899-0001
Fax(815) 899-0002
Organization SubpartNo
Authorized OfficialMark Alan RegnierPresident · (815) 899-0001
Enumeration DateJuly 18, 2011
✔ NPI 1912295494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in IL · 036097453
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.
1830 MEDITERRANEAN DR, Sycamore, IL 60178
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Other Identifiers 1

Medicaid036097453IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 14D2037551

Genesis Pediatric Medicine · Sycamore, IL
Active · expires Feb 29, 2028
CLIA Number14D2037551
Laboratory TypePhysician Office
Certificate Effective DateMarch 1, 2026
Certificate Expiration DateFebruary 29, 2028
Laboratory DirectorMark A. Regnier
Laboratory Phone(815) 899-0001
Laboratory LocationGenesis Pediatric Medicine1680 Mediterranean Dr, Sycamore, IL 60178
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 7

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

JAMES MICHAEL MATHEU DO
Family Medicine
1830 MEDITERRANEAN DR
SYCAMORE, IL 60178
Dekalb County (815) 306-2700
MEERA KATARIA ATKINS, MD, SC
Obstetrics & Gynecology
1830 MEDITERRANEAN DR
SYCAMORE, IL 60178
Dekalb County (815) 895-3800
JAYLENE M JENNINGS PA-C
Physician Assistant
1830 MEDITERRANEAN DR
SYCAMORE, IL 60178
Dekalb County (815) 766-3873
DR. AMULYA REDDY D.O.
Internal Medicine (Gastroenterology)
1830 MEDITERRANEAN DR
SYCAMORE, IL 60178
Dekalb County (815) 766-3873
DR. LISA D CRUTCHER M.D.
Family Medicine
1830 MEDITERRANEAN DR
SYCAMORE, IL 60178
Dekalb County (815) 306-2700
MARK ALAN REGNIER M.D.
Pediatrics
1830 MEDITERRANEAN DR
SYCAMORE, IL 60178
Dekalb County (815) 899-0001
NEHA VOHRA KAISER DO
Internal Medicine (Gastroenterology)
1830 MEDITERRANEAN DR
SYCAMORE, IL 60178
Dekalb County (815) 766-3873

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 Genesis Pediatric Medicine, LLC's NPI number?

The NPI number for Genesis Pediatric Medicine, LLC is 1912295494. It was assigned to this organization in the NPPES registry on July 18, 2011.

Where is Genesis Pediatric Medicine, LLC located?

Genesis Pediatric Medicine, LLC is located at 1830 Mediterranean Dr, Sycamore, IL 60178. The listed phone number is (815) 899-0001.

What is Genesis Pediatric Medicine, LLC's specialty?

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

Does Genesis Pediatric Medicine, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2037551) is associated with this NPI, valid through February 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Genesis Pediatric Medicine, LLC was last updated on July 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.