Organization
83RD PROFESSIONAL GROUP LLC
Active
Organization
83RD PROFESSIONAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TALAT GHAUS MD (OWNER/ MANAGER)
(630) 234-4895
Entity
Organization
Contact information
Practice address
6723 KINGREY HIGHWAY, WILLOWBROOK, IL 60527
(630) 850-0600
(630) 850-0608
Mailing address
6723 KINGREY HIGHWAY, WILLOWBROOK, IL 60527
(630) 850-0600
(630) 850-0608
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
05/28/2015
Last updated
09/18/2015
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