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Organization
MEDIVERSE PROFESSIONAL GROUP PLLC
Active
Organization
MEDIVERSE PROFESSIONAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
USMAN K QADEER (AUTHORIZED OFFICIAL)
(607) 738-0240
Entity
Organization
Contact information
Practice address
2210 MIDWEST RD STE 111, OAK BROOK, IL 60523-8206
(888) 632-1240
(312) 807-3550
Mailing address
2210 MIDWEST RD STE 111, OAK BROOK, IL 60523-8206
(888) 632-1240
(312) 807-3550
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/11/2026
Last updated
08/11/2026
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