Healthcare Provider Details

I. General information

NPI: 1891834883
Provider Name (Legal Business Name): OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2080 SPRINGER DR
LOMBARD IL
60148-6402
US

IV. Provider business mailing address

720 COOL SPRINGS BLVD SUITE 300
FRANKLIN TN
37067-2626
US

V. Phone/Fax

Practice location:
  • Phone: 630-932-4540
  • Fax: 630-932-4745
Mailing address:
  • Phone: 615-778-4066
  • Fax: 615-778-9114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

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