Provider Demographics
NPI:1396317111
Name:PSYCHIATRY PHYSICIANS GROUP LLC
Entity type:Organization
Organization Name:PSYCHIATRY PHYSICIANS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:OWEN FOSTER
Authorized Official - Last Name:DERANJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:331-222-7985
Mailing Address - Street 1:2021 MIDWEST RD STE 202
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1368
Mailing Address - Country:US
Mailing Address - Phone:331-234-7287
Mailing Address - Fax:331-204-0796
Practice Address - Street 1:2021 MIDWEST RD STE 202
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1368
Practice Address - Country:US
Practice Address - Phone:331-234-7287
Practice Address - Fax:331-204-0796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryGroup - Single Specialty