MEDICARE: VIRTUO PROFESSIONAL GROUP 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	261Q00000X	Clinic/Center
2	261QM1300X	Multi-Specialty Clinic/Center

General Provider Information

NPI Number	:	1780351049
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRTUO PROFESSIONAL GROUP LLC

Provider Business Mailing Address
First Line	:	2210 MIDWEST RD STE 107
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-8201
Country	:	US
Telephone Number	:	888-632-1240
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 MIDWEST RD STE 107
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-8201
Country	:	US
Telephone Number	:	888-632-1240
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	USMAN K QADEER
Credential	:	MD
Telephone Number	:	607-738-0240

Provider Enumeration Date	:	08/25/2021
Last Update Date	:	04/15/2026

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