Provider Demographics
NPI:1598203390
Name:HEALTH HUB, LLC
Entity Type:Organization
Organization Name:HEALTH HUB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PRASHANTH
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMRAGOURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-750-7920
Mailing Address - Street 1:1909 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-2602
Mailing Address - Country:US
Mailing Address - Phone:630-750-7920
Mailing Address - Fax:
Practice Address - Street 1:1909 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2602
Practice Address - Country:US
Practice Address - Phone:630-750-7920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-01
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361380172084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty