Provider Demographics
NPI:1588019517
Name:ABLE PSYCHIATRY LLC
Entity Type:Organization
Organization Name:ABLE PSYCHIATRY LLC
Other - Org Name:ABLE PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDULLAH
Authorized Official - Middle Name:KHALIL
Authorized Official - Last Name:SALLAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-308-6153
Mailing Address - Street 1:561 W DIVERSEY PKWY STE 215
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1682
Mailing Address - Country:US
Mailing Address - Phone:773-906-4546
Mailing Address - Fax:773-304-4549
Practice Address - Street 1:561 W. DIVERSEY PKWY
Practice Address - Street 2:SUITE 210
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614
Practice Address - Country:US
Practice Address - Phone:773-906-4546
Practice Address - Fax:773-304-4549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-27
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361241092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty