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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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