Tinley Park Pediatric Associates SC

Organization Active NPI Pediatrics Physician · Tinley Park, IL

NPI 1346230232 · NPPES record last updated Oct 22, 2007

Key facts

NPI
1346230232
Entity type
Organization (NPI type 2)
Primary specialty
Pediatrics Physician 208000000X
Legal business name
TINLEY PARK PEDIATRIC ASSOCIATES SC
Practice address
6703 159TH St
Suite 115
Tinley Park, IL 60477-1781
Phone
(708) 342-7032
Fax
(708) 342-7085
NPI assigned
Oct 24, 2005
Organization subpart
No

Authorized official

Name
Denice D Cook, M.D.
Title
President
Phone
(708) 342-7032

Practitioners 2

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208000000X Yes

Addresses

Primary practice location

6703 159TH St
Suite 115
Tinley Park, IL 60477-1781

Mailing address

PO Box 789
Matteson, IL 60443-0789
Phone (708) 747-5850

Other identifiers

IdentifierTypeStateIssuer
1634171OtherBCBSIL GROUP NUMBER

Other providers in Tinley Park, IL

All providers in Tinley Park, IL · Pediatrics Physician in Illinois

Sources for this page

Verify at the official NPI Registry.