# SOUTH PARK PEDIATRICS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Park Pediatrics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649638685
- **Authorized official:** DR. WENDELL A WHEELER M.D. (PRESIDENT)
- **Authorized official phone:** (708) 225-0200

## Contact information

- **Practice address:** 15821 S PARK AVE, SOUTH HOLLAND, IL 60473-1506
- **Practice address phone:** (708) 225-0200
- **Practice address fax:** (708) 225-0202
- **Mailing address:** 15821 S PARK AVE, SOUTH HOLLAND, IL 60473-1506
- **Mailing address phone:** (708) 225-0200
- **Mailing address fax:** (708) 225-0202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 036068196 | IL | Yes |

## Other

- **Enumeration date:** 02/05/2016
- **Last updated:** 02/05/2016