NPIMap

Organization Active NPI

Mediverse Professional Group PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Brook, IL
National Provider Identifier
1447175138
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MEDIVERSE PROFESSIONAL GROUP PLLC
Practice address
2210 Midwest Rd Ste 111
Oak Brook, IL 60523-8206
Phone
(888) 632-1240
Fax
(312) 807-3550
NPI assigned
Aug 11, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Usman K QadeerNPI 1467728378
Title
Authorized Official
Phone
(607) 738-0240

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

2210 Midwest Rd Ste 111
Oak Brook, IL 60523-8206

Mailing address

2210 Midwest Rd Ste 111
Oak Brook, IL 60523-8206
Phone (888) 632-1240

National Provider Directory

National Provider Directory
Tax ID family
Mediverse Professional Group PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2210 Midwest Rd
Ste 111
Oak Brook, IL 60523

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1786406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1447175138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 MIDWEST RD STE 111",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238206",
            "telephone_number": "888-632-1240",
            "fax_number": "312-807-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 MIDWEST RD STE 111",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238206",
            "telephone_number": "888-632-1240",
            "fax_number": "312-807-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVERSE PROFESSIONAL GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-11",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "QADEER",
        "authorized_official_first_name": "USMAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "607-738-0240"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.