MEDIVERSE PROFESSIONAL GROUP PLLC NPI 1902695497

NPI Information

  • NPI: 1902695497
  • Provider Name: MEDIVERSE PROFESSIONAL GROUP PLLC
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • Address: 1S131 SUMMIT AVE
    OAKBROOK TERRACE, IL
    ZIP 60181
  • Phone: (574) 800-1646

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NPI Details

MEDIVERSE PROFESSIONAL GROUP PLLC is a multi-specialty clinic center in Oakbrook Terrace, IL. MEDIVERSE PROFESSIONAL GROUP PLLC NPI is 1902695497. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1S131 SUMMIT AVE
OAKBROOK TERRACE, IL
ZIP 60181-904
Phone: (574) 800-1646

The provider's authorized official is Usman Kareem Qadeer .
The authorized official title is President and has the following contact phone number (574) 800-1646.

The enumeration date for this NPI number is 5/2/2025 and was last updated on 5/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurologyNo
22084P0800XPsychiatry & NeurologyPsychiatryNo
3261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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