Healthcare Provider Details

I. General information

NPI: 1114836897
Provider Name (Legal Business Name): TPK HEALING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

627 N YORK ST
ELMHURST IL
60126-1620
US

IV. Provider business mailing address

627 N YORK ST
ELMHURST IL
60126-1620
US

V. Phone/Fax

Practice location:
  • Phone: 346-771-1189
  • Fax:
Mailing address:
  • Phone: 346-771-1189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TARAKA PAVAN KALYAN ORSU
Title or Position: URGENT CARE
Credential:
Phone: 346-771-1189