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PEDIATRUST, L.L.C.
NPI 1982958013
Pediatrics in Lake Forest, IL

Active since October 26, 2012CLIA Certified · 2 labs
900 N WESTMORELAND RD, SUITE 217, LAKE FOREST, IL 60045(847) 615-0700 Get Directions Write a Review

NPPES record last updated: March 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pediatrust, L.l.c. NPPES

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

PEDIATRUST, L.L.C. (NPI 1982958013) is a healthcare organization registered as a pediatrics in Lake Forest, Illinois and active in the NPI registry since October 2012. The organization holds 2 active CLIA laboratory certificates and lists Susan Sirota, Ceo, as its authorized official.

NPPES Registry Identity

NPI1982958013
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NamePEDIATRUST, L.L.C.
Location Address900 N WESTMORELAND RD, SUITE 217Lake Forest, IL 60045-1674
Mailing Address2375 Waterview Dr Ste Sm100Northbrook, IL 60062-6145 · (224) 330-6311 · Fax (224) 330-6325
Phone(847) 615-0700
Organization SubpartNo
Authorized OfficialSusan SirotaCeo · (224) 330-6300
Enumeration DateOctober 26, 2012
Last NPPES UpdateMarch 22, 2024
NPPES CertifiedMarch 22, 2024
✔ NPI 1982958013 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.
900 N WESTMORELAND RD, Lake Forest, IL 60045
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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 2

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 52D2264012

Pediatrust · Eagle River, WI
Active · expires Jul 7, 2028
CLIA Number52D2264012
Laboratory TypeIndependent
Certificate Effective DateJuly 8, 2026
Certificate Expiration DateJuly 7, 2028
Laboratory DirectorDr. Joshua D. Levin
Laboratory Phone(224) 330-6300
Laboratory LocationPediatrust4040 Ojibwa Dr, Eagle River, WI 54521
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 52D2224962

Pedia Trust · Eagle River, WI
Active · expires May 17, 2027
CLIA Number52D2224962
Laboratory TypeIndependent
Certificate Effective DateMay 18, 2025
Certificate Expiration DateMay 17, 2027
Laboratory DirectorDr. Joshua D. Levin
Laboratory Phone(224) 330-6300
Laboratory LocationPedia Trust3782 Gaffney Drive, Eagle River, WI 54521
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

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

LAKE SHORE PEDIATRICS, LTD
Pediatrics
900 N WESTMORELAND RD, SUITE 106
LAKE FOREST, IL 60045
Lake County (847) 615-4654
TANNER L COLEGROVE M.D.
Obstetrics & Gynecology
900 N WESTMORELAND RD, SUITE # 207
LAKE FOREST, IL 60045
Lake County (847) 234-9110
MELISSA HILB CPNP
Nurse Practitioner (Pediatrics)
900 N WESTMORELAND RD, SUITE 110
LAKE FOREST, IL 60045
Lake County (847) 295-1220
NORTH SHORE RHEUMATOLOGY
Internal Medicine (Rheumatology)
900 N WESTMORELAND RD, SUITE 222
LAKE FOREST, IL 60045
Lake County (847) 234-6121
DR. DENISE VERGES MD
Internal Medicine (Rheumatology)
900 N WESTMORELAND RD, SUITE 222
LAKE FOREST, IL 60045
Lake County (847) 234-6121
NORTHWESTERN MEDICAL FACULTY FOUNDATION
Optometrist
900 N WESTMORELAND RD, LOWER LEVEL 88
LAKE FOREST, IL 60045
Lake County (847) 295-0001
JHAN CARLO FONTANILLA DPT
Physical Therapist
900 N WESTMORELAND RD
LAKE FOREST, IL 60045
Lake County (847) 535-6418
DR. REBECCA E JACOBSON MD
Obstetrics & Gynecology
900 N WESTMORELAND RD, STE 228
LAKE FOREST, IL 60045
Lake County (847) 234-3860

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 Pediatrust, L.L.C.'s NPI number?

The NPI number for Pediatrust, L.L.C. is 1982958013. It was assigned to this organization in the NPPES registry on October 26, 2012.

Where is Pediatrust, L.L.C. located?

Pediatrust, L.L.C. is located at 900 N Westmoreland Rd Suite 217, Lake Forest, IL 60045. The listed phone number is (847) 615-0700.

What is Pediatrust, L.L.C.'s specialty?

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

Does Pediatrust, L.L.C. hold CLIA laboratory certificates?

Yes. 2 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 Pediatrust, L.L.C. was last updated on March 22, 2024. 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.