Healthcare Provider Details

I. General information

NPI: 1699721134
Provider Name (Legal Business Name): OB-GYN HEALTH ASSOCIATES SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16011 108TH AVE
ORLAND PARK IL
60467-8786
US

IV. Provider business mailing address

16011 108TH AVE STE B
ORLAND PARK IL
60467-8787
US

V. Phone/Fax

Practice location:
  • Phone: 708-873-2000
  • Fax: 708-364-0430
Mailing address:
  • Phone: 708-873-2000
  • Fax: 708-364-0430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: JESSICA DY-JOHNSON
Title or Position: OWNER/OFFICER
Credential: MD
Phone: 708-873-2000