Organization Active NPI

Pediatric Health Partners, S.C.

  • Pediatrics Physician
  • Chicago Ridge, IL
National Provider Identifier
1194865287
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC HEALTH PARTNERS, S.C.
Practice address
10436 Southwest Hwy
Chicago Ridge, IL 60415-2282
Phone
(708) 636-0700
Fax
(708) 636-3849
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mary Ann Collins, M.D.
Title
M.D.
Phone
(708) 636-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

10436 Southwest Hwy
Chicago Ridge, IL 60415-2282

Mailing address

10436 Southwest Hwy
Chicago Ridge, IL 60415-2282
Phone (708) 636-0700

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0881430Pediatric Health Partners SC10436 Southwest Highway, Chicago Ridge, IL 60415Certificate of waiverJan 10, 2028

National Provider Directory

National Provider Directory

Locations

10436 Southwest Hwy
Ste 2
Chicago Ridge, IL 60415
Phone (708) 636-0700

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194865287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10436 SOUTHWEST HWY",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152282",
            "telephone_number": "708-636-0700",
            "fax_number": "708-636-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10436 SOUTHWEST HWY",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152282",
            "telephone_number": "708-636-0700",
            "fax_number": "708-636-3849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HEALTH PARTNERS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "708-636-0700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.