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General NPI Number Information
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NPI Number | 1982993994
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Entity Type | Organization
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Legal Business Name | PSYCHOPHARMACOLOGY CLINICS OF AMERICA, S.C.
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Dates
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Enumeration Date | 03/30/2011
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 1200 HARGER RD SUITE 415
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City | OAK BROOK
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State | IL
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Zip | 60523-1805
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Country | US
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Telephone | 630-928-1000
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Fax | 630-928-0020
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Provider Business Mailing Address
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Address Line | 1200 HARGER RD SUITE 415
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City | OAK BROOK
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State | IL
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Zip | 60523-1805
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Country | US
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Telephone | 630-928-1000
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Fax | 630-928-0020
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Authorized Official
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Title or Position | PRESIDENT
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Name | MOHAMMED Y ALAM
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Credential | MD
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Telephone | 630-928-1000
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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 | 036-082013
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License Number State | IL
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