# CHILDRENS WELLNESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578748067
- **Authorized official:** MRS. KENYA WILBANKS (OFFICE MANAGER)
- **Authorized official phone:** (708) 364-1550

## Contact information

- **Practice address:** 16505 106TH CT, ORLAND PARK, IL 60467-4522
- **Practice address phone:** (708) 364-1550
- **Practice address fax:** (708) 364-1468
- **Mailing address:** 16505 106TH CT, ORLAND PARK, IL 60467-4522
- **Mailing address phone:** (708) 364-1550
- **Mailing address fax:** (708) 364-1468

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 036079532 | IL | Yes |
| 174400000X | Specialist | 036114693 | IL | — |
| 174400000X | Specialist | 036115658 | IL | — |
| 174400000X | Specialist | 036116141 | IL | — |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | NULL | Yes |
| 2080A0000X | Pediatric Adolescent Medicine Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LP0200X | Pediatric Nurse Practitioner | 209010813 | IL | — |

## Other

- **Enumeration date:** 01/03/2008
- **Last updated:** 07/07/2026