Healthcare Provider Details

I. General information

NPI: 1982254850
Provider Name (Legal Business Name): YUSUF SALAH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 W COLLEGE DR STE 102
PALOS HEIGHTS IL
60463-1181
US

IV. Provider business mailing address

6321 DEMPSTER ST
MORTON GROVE IL
60053-2848
US

V. Phone/Fax

Practice location:
  • Phone: 708-840-3733
  • Fax:
Mailing address:
  • Phone: 312-262-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: YUSUF SALAH
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 312-262-6434