HIPAA Notice of Privacy Practices

Effective Date: August 19, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Alzein Pediatrics Primary & Urgent Care (“Alzein Pediatrics,” “we,” “us,” or “our”) is required by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) to maintain the privacy of your child’s protected health information (“PHI”), to provide you with this Notice of our legal duties and privacy practices, and to abide by the terms of the Notice currently in effect. This Notice applies to all records of your child’s care generated at any of our offices.

How We May Use and Disclose Health Information

For Treatment

We may use and share your child’s PHI to provide, coordinate, and manage their medical care. For example, our pediatricians, nurses, and staff may share information with each other, with a specialist we refer your child to, with a hospital, laboratory, or pharmacy, or with another provider involved in your child’s care.

For Payment

We may use and share PHI to bill and collect payment for services — for example, submitting claims to your health insurance plan, confirming coverage and obtaining prior authorizations, and billing you for amounts you owe.

For Health Care Operations

We may use and share PHI to run our practice — for example, quality assessment and improvement, staff training and evaluation, appointment reminders, licensing, audits, and business planning. We may contact you by phone, mail, text message, or patient portal to remind you of an appointment or share information about treatment options and health-related services. You may ask us to use a specific contact method.

Other Permitted or Required Uses and Disclosures

• As required by law — including reporting suspected child abuse or neglect to state authorities.
• Public health activities — such as reporting immunizations to the Illinois immunization registry (I-CARE), communicable disease reporting, and adverse event reporting.
• Health oversight activities — audits, investigations, and inspections by government agencies.
• Judicial and administrative proceedings — in response to a court order, subpoena, or other lawful process.
• Law enforcement — in limited circumstances permitted by law.
• To avert a serious threat to the health or safety of a person or the public.
• Workers’ compensation and similar programs, as authorized by law.
• Business associates — companies that perform services for us (such as billing, IT, or an electronic health record vendor) under written contracts requiring them to protect PHI.
• Persons involved in your child’s care — we may share relevant information with a family member or other person you identify as involved in your child’s care or payment for that care.

Uses and Disclosures Requiring Your Written Authorization

We will obtain your written authorization before using or disclosing PHI for marketing purposes, before selling PHI, before disclosing psychotherapy notes (where applicable), and for any purpose not described in this Notice. You may revoke an authorization at any time in writing, except to the extent we have already acted on it.

Minors and Parental Access

As a pediatric practice, we generally treat the parent or legal guardian as the personal representative of a minor patient. Illinois law gives minors the right to consent to certain services on their own (for example, certain reproductive health, mental health, or substance use services). Where the law permits a minor to consent to care, related records may not be released to a parent or guardian without the minor’s permission, and we will follow Illinois law regarding access to those records.

Your Rights Regarding Your Child’s Health Information

• Right to inspect and copy. You may request access to your child’s medical and billing records, and receive a copy (including an electronic copy) — usually within 30 days. We may charge a reasonable, cost-based fee.
• Right to amend. If you believe information in the record is incorrect or incomplete, you may request an amendment in writing, with a reason for the request. We may deny the request in certain circumstances, and you may respond with a statement of disagreement.
• Right to an accounting of disclosures. You may request a list of certain disclosures we have made of your child’s PHI in the six years prior to your request (excluding disclosures for treatment, payment, and health care operations, among others).
• Right to request restrictions. You may ask us to limit how we use or share PHI. We are not required to agree, except that we must honor a request not to disclose information to your health plan when the disclosure is for payment or operations and you (or someone on your behalf) paid for the item or service in full, out of pocket.
• Right to confidential communications. You may ask us to contact you in a specific way or at a specific location (for example, only by cell phone). We will accommodate reasonable requests.
• Right to a paper copy of this Notice. You may request a paper copy at any time, even if you agreed to receive it electronically.
• Right to be notified of a breach. We will notify you if a breach occurs that compromises the privacy or security of your child’s unsecured PHI.

Our Duties

We are required by law to maintain the privacy and security of PHI, to provide this Notice of our legal duties and privacy practices, to notify affected individuals following a breach of unsecured PHI, and to follow the terms of the Notice currently in effect. We reserve the right to change this Notice and to make the revised Notice effective for PHI we already hold as well as information we receive in the future. The current Notice will be posted in our offices and on this website, with its effective date at the top.

Complaints

If you believe your child’s privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201, by calling 1-800-368-1019, or online at hhs.gov/ocr/complaints. You will not be penalized or retaliated against for filing a complaint.

Contact Us

To exercise any of the rights described in this Notice, ask questions, or file a complaint, contact our Privacy Officer:

Privacy Officer
Alzein Pediatrics Primary & Urgent Care
Phone: 708-424-7600

Our Locations:

• 5102 Museum Drive, Oak Lawn, IL 60453
• 5540 West 111th Street, Oak Lawn, IL 60453
• 2850 W 95th Street, Suite 400, Evergreen Park, IL 60805