Healthcare Provider Details

I. General information

NPI: 1790794584
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E. ARMY TRAIL ROAD
BLOOMINGDALE IL
60108
US

IV. Provider business mailing address

5080 SPECTRUM DRIVE SUITE 1200 WEST TOWER
ADDISON TX
75001
US

V. Phone/Fax

Practice location:
  • Phone: 630-582-8946
  • Fax: 630-582-0969
Mailing address:
  • Phone: 800-232-3550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAAD A YALDO
Title or Position: VICE PRESIDENT
Credential: DO
Phone: 972-364-8000