MEDICARE: PSYCHIATRY OASIS LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1558224121
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PSYCHIATRY OASIS LLC

Provider Business Mailing Address
First Line	:	439 US ROUTE 1 STE A
Second Line	:
City	:	YORK
State	:	ME
Zip	:	03909-1638
Country	:	US
Telephone Number	:	617-433-7129
Fax Number	:

Provider Business Practice Location Address
First Line	:	5613 DUNHAM RD
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60516-1247
Country	:	US
Telephone Number	:	617-433-7129
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	AMIR W RAAD
Credential	:	NP
Telephone Number	:	617-433-7129

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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