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WHOLE HEALTH MAMA PEDIATRICS SC NPI 1073025045


NPI Information

NPI: 1073025045
Provider Name: WHOLE HEALTH MAMA PEDIATRICS, SC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 14D2149037

Address:
13740 ELM ST
ORLAND PARK, IL
ZIP 60462
Phone: (708) 460-9833
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WHOLE HEALTH MAMA PEDIATRICS, SC is a pediatrics in Orland Park, IL. The provider is 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. WHOLE HEALTH MAMA PEDIATRICS, SC NPI is 1073025045. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

13740 ELM ST
ORLAND PARK, IL
ZIP 60462-510
Phone: (708) 460-9833
Fax: (708) 460-1117

The provider's authorized official is Nicole Mozden .
The authorized official title is President and has the following contact phone number (312) 218-8748.

The CLIA number assigned to this NPI record is 14D2149037 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2017 and was last updated on 10/31/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics036116141ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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