Provider Demographics
NPI:1689132789
Name:OCCUPATIONAL HEALTH CENTERS OF ILLINOIS
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH CENTERS OF ILLINOIS
Other - Org Name:
Other - Org Type:
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 STE 1200W
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4624
Mailing Address - Country:US
Mailing Address - Phone:972-725-6423
Mailing Address - Fax:
Practice Address - Street 1:5015 W 65TH ST
Practice Address - Street 2:
Practice Address - City:BEDFORD PARK
Practice Address - State:IL
Practice Address - Zip Code:60638-5701
Practice Address - Country:US
Practice Address - Phone:708-924-8000
Practice Address - Fax:708-924-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
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