Provider Demographics
NPI:1659536456
Name:OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH CENTERS OF ILLINOIS PC
Other - Org Name:DBA, CONCENTRA MEDICAL CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:YALDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-364-8000
Mailing Address - Street 1:5080 SPECTRUM DR
Mailing Address - Street 2:SUITE 1200 WEST TOWER
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4648
Mailing Address - Country:US
Mailing Address - Phone:800-232-3550
Mailing Address - Fax:
Practice Address - Street 1:2430 RIVER DR
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-1564
Practice Address - Country:US
Practice Address - Phone:309-736-6009
Practice Address - Fax:309-762-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine