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NPI 1780693614

NPI 1780693614 : OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC : ELK GROVE VILLAGE, IL

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General NPI Number Information
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    NPI Number           |    1780693614
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    Entity Type          |    Organization 
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    Legal Business Name  |    OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC 
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Dates
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    Enumeration Date     |    08/07/2006
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    Last Update Date     |    06/20/2025
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Provider Practice Location Address
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    Address Line         |    1830 JARVIS AVENUE 
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    City                 |    ELK GROVE VILLAGE
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    State                |    IL
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    Zip                  |    60007
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    Country              |    US
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    Telephone            |    847-952-1180
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    Fax                  |    847-952-1183
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Provider Business Mailing Address
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    Address Line         |    5080 SPECTRUM DRIVE SUITE 1200 WEST TOWER
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    City                 |    ADDISON
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    State                |    TX
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    Zip                  |    75001
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    Country              |    US
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    Telephone            |    800-232-3550
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    Fax                  |    
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Authorized Official
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    Title or Position    |    VICE PRESIDENT
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    Name                 |     RAAD A YALDO 
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    Credential           |    DO
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    Telephone            |    972-364-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QH0100X
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    Taxonomy Name        |    Health Service Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QP2000X
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    Taxonomy Name        |    Physical Therapy Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    261QX0100X
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    Taxonomy Name        |    Occupational Medicine Clinic/Center
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    License Number       |    
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    License Number State |    
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