Provider Demographics
NPI:1114368412
Name:OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAAD
Authorized Official - Middle Name:
Authorized Official - Last Name:YALDO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-364-8000
Mailing Address - Street 1:5080 SPECTRUM DR
Mailing Address - Street 2:SUITE 1200 WEST
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:972-364-8000
Mailing Address - Fax:214-775-4502
Practice Address - Street 1:8755 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455-1905
Practice Address - Country:US
Practice Address - Phone:708-430-2295
Practice Address - Fax:708-430-2372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-15
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine