Basic Information
| Provider Information | |||||||||
| NPI: | 1831757301 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PITSTICK | ||||||||
| FirstName: | CLAIRE | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7222 W CERMAK RD | ||||||||
| Address2: | SUITE 504 | ||||||||
| City: | NORTH RIVERSIDE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732846270 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7222 W CERMAK RD STE 504 | ||||||||
| Address2: | |||||||||
| City: | NORTH RIVERSIDE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605461443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732846270 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2019 | ||||||||
| LastUpdateDate: | 06/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 036.159925 | IL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.