Professional Psychiatry Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036-113634 Issued in IL

Legal business name

PROFESSIONAL PSYCHIATRY INC.

Practice address

4433 W Touhy Ave Ste 262
Lincolnwood, IL 60712-1833

Phone

(847) 312-3376

NPI assigned

Mar 3, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Ghazala Fayyaz, M.D

Title

President

Phone

(847) 312-3506

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1528366234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9446 LATROBE AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771112",
            "telephone_number": "847-312-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4433 W TOUHY AVE STE 262",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607121833",
            "telephone_number": "847-312-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL PSYCHIATRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-03",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "FAYYAZ",
        "authorized_official_first_name": "GHAZALA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-312-3506",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036-113634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036113634",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Podiatry Services, LTD
• Premium Home Health Care, Inc.
• Prime Care Home Health Services LLC
• Primecare Home Health Services Inc.
• Frank Joseph Pristera, PHARMD
• Elizabeth Pullen, PSY.D.
• Anna Purinson, M.D.
• Quality Medical Supplies Inc
• Quality Medical Supplies Inc
• Jennifer Quintero

• Psychiatry Physician in Lincolnwood, IL
• Providers in Lincolnwood, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.