Organization
PROFESSIONAL PSYCHIATRY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GHAZALA FAYYAZ M.D (PRESIDENT)
(847) 312-3506
Entity
Organization
Contact information
Practice address
4433 W TOUHY AVE STE 262, LINCOLNWOOD, IL 60712-1833
(847) 312-3376
Mailing address
9446 LATROBE AVE, SKOKIE, IL 60077-1112
(847) 312-4219
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036-113634
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113634
—
IL
Enumeration date
03/03/2011
Last updated
09/09/2013
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