OrganizationActive
Children'S Physician Group
NPI 1124362306 · Pediatric Cardiology Physician · Crystal Lake, IL
Provider details
- NPI number
- 1124362306
- Entity type
- Organization
- Primary specialty
- Pediatric Cardiology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Children'S Physician Group
- Organization subpart
- Yes
- Authorized official
- Smriti Khare, President, Children'S Physician Grp(414) 266-7615
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
360 Station Dr
Crystal Lake, IL 60014-7978
Phone: (815) 338-6600
Fax: (815) 477-9826
Approximate (ZIP-level) locationGet directions
Mailing address
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Other names (DBA / former)
- Doing business as
- Crystal Lake Clinic
Registry dates
- Enumerated
- 2012-11-12
- Last updated
- 2012-11-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.