MEDICARE: OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QP2000X	Physical Therapy Clinic/Center
2	261QX0100X	Occupational Medicine Clinic/Center
3	261QH0100X	Health Service Clinic/Center

General Provider Information

NPI Number	:	1659536456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DR
Second Line	:	SUITE 1200 WEST TOWER
City	:	ADDISON
State	:	TX
Zip	:	75001-4648
Country	:	US
Telephone Number	:	800-232-3550
Fax Number	:

Provider Business Practice Location Address
First Line	:	2430 RIVER DR
Second Line	:
City	:	MOLINE
State	:	IL
Zip	:	61265-1564
Country	:	US
Telephone Number	:	309-736-6009
Fax Number	:	309-762-7760

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAAD A YALDO
Credential	:
Telephone Number	:	972-364-8000

Provider Enumeration Date	:	07/22/2008
Last Update Date	:	09/13/2018

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