MEDICARE: WHOLE HEALTH MAMA PEDIATRICS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	036116141	IL

General Provider Information

NPI Number	:	1073025045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHOLE HEALTH MAMA PEDIATRICS

Provider Business Mailing Address
First Line	:	13740 ELM STREET
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-1510
Country	:	US
Telephone Number	:	312-218-8748
Fax Number	:	708-460-3067

Provider Business Practice Location Address
First Line	:	7330 COLLEGE DRIVE
Second Line	:	SUITE 201
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1184
Country	:	US
Telephone Number	:	708-671-8145
Fax Number	:	708-608-8089

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NICOLE MOZDEN
Credential	:	MD
Telephone Number	:	312-218-8748

Provider Enumeration Date	:	10/31/2017
Last Update Date	:	09/09/2025

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