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

Wicked Wellness Spa PLLC

Organization Family Medicine Physician · NPI 1104610286

Wicked Wellness Spa PLLC is a Family Medicine Physician in Tinley Park, Illinois. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6700 167th St Ste 4&5
Tinley Park, IL 60477-2859
Phone: (708) 781-3007
Fax: (708) 600-2005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1104610286
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Phylia Bolls — Owner · (708) 600-2005
NPI enumeratedApril 5, 2025
Last updated in NPPESApril 5, 2025
Certification dateApril 5, 2025
Mailing address6700 167th St Ste 4&5, Tinley Park, IL 60477-2859

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