Provider Demographics
NPI:1609180918
Name:HINSDALE BEHAVIORAL HEALTH CLINIC
Entity Type:Organization
Organization Name:HINSDALE BEHAVIORAL HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TALAT
Authorized Official - Middle Name:D
Authorized Official - Last Name:GHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-850-0600
Mailing Address - Street 1:40 S CLAY ST STE 229
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3257
Mailing Address - Country:US
Mailing Address - Phone:630-920-1795
Mailing Address - Fax:
Practice Address - Street 1:40 S CLAY ST STE 229
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3257
Practice Address - Country:US
Practice Address - Phone:630-920-1795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-28
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360789282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty