Healthcare Provider Details

I. General information

NPI: 1154650042
Provider Name (Legal Business Name): ORLAND FAMILY INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 12/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15010 S RAVINIA AVE SUITE 15
ORLAND PARK IL
60462-3162
US

IV. Provider business mailing address

15010 S RAVINIA AVE SUITE 15
ORLAND PARK IL
60462-3162
US

V. Phone/Fax

Practice location:
  • Phone: 708-364-0580
  • Fax: 708-364-0480
Mailing address:
  • Phone: 708-364-0580
  • Fax: 708-364-0480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036103889
License Number StateIL

VIII. Authorized Official

Name: DR. MARTINS A ADEOYE
Title or Position: MANAGER / CEO
Credential: MD
Phone: 708-364-0580