Healthcare Provider Details
I. General information
NPI: 1922960921
Provider Name (Legal Business Name): GOPT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/27/2025
Last Update Date: 11/27/2025
Certification Date: 11/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4824 148TH ST
MIDLOTHIAN IL
60445-3117
US
IV. Provider business mailing address
4824 148TH ST
MIDLOTHIAN IL
60445-3117
US
V. Phone/Fax
- Phone: 312-624-8364
- Fax: 312-929-3323
- Phone: 312-624-8364
- Fax: 312-929-3323
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111NR0400X |
| Taxonomy | Rehabilitation Chiropractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NEEMA
BAYRAN
Title or Position: C.E.O.
Credential: MD
Phone: 312-531-1580