Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pediatric and Adolescent Gastroenterology Group Inc

Organization Pediatric Gastroenterology Physician · NPI 1336323484

Pediatric and Adolescent Gastroenterology Group Inc is a Pediatric Gastroenterology Physician in Melrose Park, Illinois. Licensed in Illinois and Indiana. Registered with an NPI since 2007.

Licensed in
IL, IN
In the registry since
2007
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1225 W Lake St Ste 409
Melrose Park, IL 60610
Phone: (708) 499-7510
Fax: (708) 345-0332
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Gastroenterology Physician (primary) Taxonomy 2080P0206X · Licence 036062537 (IL)
Pediatric Gastroenterology Physician Taxonomy 2080P0206X · Licence 1000155902 (IN)

Record details

NPI number1336323484
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gloria Buentello — Md · (708) 499-7510
NPI enumeratedDecember 26, 2007
Last updated in NPPESJune 13, 2011
Mailing address47 W Division St Unit 142, Chicago, IL 60610-2220

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