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General NPI Number Information
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NPI Number | 1962313676
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Entity Type | Organization
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Legal Business Name | THE PHYSICIANS ON US GROUP
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Dates
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Enumeration Date | 09/14/2026
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Last Update Date | 09/14/2026
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Provider Practice Location Address
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Address Line | 111 N WABASH AVE UNIT 3541
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-409-0417
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Fax | 276-777-7708
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Provider Business Mailing Address
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Address Line | 111 N WABASH AVE UNIT 3541
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City | CHICAGO
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State | IL
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Zip | 60602-1903
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Country | US
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Telephone | 312-409-0417
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Fax | 276-777-7708
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Authorized Official
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Title or Position | PRESIDENT & PRACTITIONER
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Name | MR. VINCENT JAMES EDWARDS SR.
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Credential | PRACTITIONER
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Telephone | 312-409-0417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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