Healthcare Provider Details

I. General information

NPI: 1356432967
Provider Name (Legal Business Name): MIDWEST PSYCHIATRY ASSOCIATES SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 04/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8311 ROOSEVELT RD
FOREST PARK IL
60130-2529
US

IV. Provider business mailing address

602 MALLARD LN
OAK BROOK IL
60523-2774
US

V. Phone/Fax

Practice location:
  • Phone: 708-771-7000
  • Fax: 708-366-1017
Mailing address:
  • Phone: 630-915-1410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. HUMARIA SAIYED
Title or Position: OWNER
Credential: MD
Phone: 630-915-1410