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General NPI Number Information
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NPI Number | 1225134976
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Entity Type | Organization
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Legal Business Name | ADI PEDIATRIC BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 W CENTRAL #405
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60005
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Country | US
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Telephone | 847-577-7705
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Fax | 547-577-7712
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Provider Business Mailing Address
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Address Line | 38785 N DREXEL BLVD
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City | ANITOCH
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State | IL
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Zip | 60002
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Country | US
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Telephone | 847-577-7705
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Fax | 847-577-7712
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Authorized Official
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Title or Position | OWNER
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Name | ATULA SHARMA
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Credential | MD
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Telephone | 847-577-7705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State | IL
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