Provider Demographics
NPI:1982254850
Name:YUSUF SALAH LLC
Entity type:Organization
Organization Name:YUSUF SALAH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:YUSUF
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-262-6434
Mailing Address - Street 1:6321 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-2848
Mailing Address - Country:US
Mailing Address - Phone:312-262-6434
Mailing Address - Fax:
Practice Address - Street 1:7300 W COLLEGE DR STE 102
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1181
Practice Address - Country:US
Practice Address - Phone:708-840-3733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-12
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty