Provider Demographics
NPI:1154650042
Name:ORLAND FAMILY INSTITUTE LLC
Entity Type:Organization
Organization Name:ORLAND FAMILY INSTITUTE LLC
Other - Org Name:OPTIMAL CENTER FOR BEHAVIORAL AND AESTHETIC MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTINS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADEOYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-364-0580
Mailing Address - Street 1:15010 S RAVINIA AVE
Mailing Address - Street 2:SUITE 15
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3162
Mailing Address - Country:US
Mailing Address - Phone:708-364-0580
Mailing Address - Fax:708-364-0480
Practice Address - Street 1:15010 S RAVINIA AVE
Practice Address - Street 2:SUITE 15
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3162
Practice Address - Country:US
Practice Address - Phone:708-364-0580
Practice Address - Fax:708-364-0480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361038892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty