DR. TALHA JOHN BALOCH (NPI# 1548640535) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548640535 |
Entity Type | Individual |
Full Name | DR. TALHA JOHN BALOCH |
Credential | M.D. |
Practice Address |
12255 S 80th Ave Palos Heights IL 60463-1270 |
Mailing Address |
12251 S 80th Ave Ste 1630 Palos Heights IL 60463-1256 |
Practice Telephone | 7089237878 |
Practice Fax Number | 7089237888 |
Mailing Telephone | 7089237878 |
Mailing Fax Number | 7089237888 |
Enumeration Date | 2015-06-04 |
Last Update Date | 2020-08-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
036144624 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 036144624 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
901 W Jefferson St, Springfield, IL 627024833 | 2175458229 | 2175452275 |
Street Address |
12255 S 80TH AVE |
City | PALOS HEIGHTS |
State | IL |
Zip Code | 60463-1270 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356330286 | Bruce R Dolitsky | Orthopaedic Surgery | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2005-10-13 |
1699387910 | Wilma Montilla-rener | Nurse Practitioner | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2020-08-18 |
1780048058 | Debora Delre | Nurse Practitioner | 12255 S 80th Ave, Suite 202, Palos Heights, IL 60463-1258 | 2016-04-12 |
1306203757 | Shelley Kay Mayer-zich | Nurse Practitioner | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2016-01-15 |
1881078392 | Radhika Chimata | Psychiatry & Neurology | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2015-07-14 |
1326482688 | Anmol Tolani | Psychiatry & Neurology | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2013-04-17 |
1558625251 | Anthony Casini | Surgery | 12255 S 80th Ave, Palos Heights, IL 60463 | 2012-06-27 |
1548532591 | Darlene C Flowers | Nurse Practitioner | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2012-02-07 |
1760776173 | Imad Qayyum | Surgery | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2011-06-02 |
1720243025 | Sameen Ahmad | Psychiatry & Neurology | 12255 S 80th Ave, Palos Heights, IL 60463-1270 | 2008-07-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932756095 | Kim Rusiecki | Technician | 25 Parliament Drive East, Palos Heights, IL 60463 | 2019-08-23 |
1265925218 | Sentinel Anesthesia of Illinois, PC | Anesthesiology | 7340 W College Dr Fl 1, Palos Heights, IL 60463 | 2018-06-13 |
1225410848 | Deborah Ann Castaneda | Skilled Nursing Facility | 12350 Natchez Ave., Palos Heights, IL 60463 | 2015-06-19 |
1609253160 | Tareq Ayyad | Physical Therapy Assistant | 11730 Lighthouse Ln, Palos Heights, IL 60463 | 2015-05-04 |
1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
1275976045 | Nazim A. Khan | Physician Assistant | 6450 West College Drive, Palos Heights, IL 60463 | 2013-04-11 |
1619246824 | Amanda M Ejka | Psychologist | 11800 South 75th Avenue, Suite 300, Palos Heights, IL 60463 | 2011-12-16 |
1578832937 | Sandi Maheras | Pharmacist | 1703 Spyglass Cir, Palos Heights, IL 60463 | 2011-12-14 |
1043597065 | Ashraf Olwan | Pharmacist | 7660 W Sequoia Rd, Palos Heights, IL 60463 | 2011-11-04 |
Find all providers in zip 60463 |
Taxonomy Code | 2084A0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Addiction Medicine |
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144741844 | Rose Medical Association, Inc. | Psychiatry & Neurology | 209 W Romeo B Garrett Ave, Peoria, IL 61605-2502 | 2017-07-03 |
1215208491 | Fred M Levin Md Sc | Psychiatry & Neurology | 111 N. Wabash Avenue, Suite 1022, Chicago, IL 60602-1903 | 2012-01-20 |
1568525277 | Usha D Malkerneker | Psychiatry & Neurology | 17100 Dixie Hwy Ste D, Hazel Crest, IL 60429-1485 | 2006-12-18 |
1891899258 | Kenneth Lawrence Moore | Psychiatry & Neurology | 12 Tartan Ridge Rd, Burr Ridge, IL 60527-8904 | 2006-09-07 |
1508979758 | Charles R Harris | Psychiatry & Neurology | 12230 Cashlenan Ln, New Lenox, IL 60451-2799 | 2006-08-15 |
1255340097 | Michael Rachman | Psychiatry & Neurology | 1375 E Schaumburg Road, Suite 260, Schaumburg, IL 60194-3658 | 2006-08-07 |
1245217959 | Raymond Christopher Garcia | Psychiatry & Neurology | 8616 Northern Ave, Rockford, IL 61107-5309 | 2005-12-23 |
1184610107 | Lucy Ibrahim | Psychiatry & Neurology | 1280 Windham Pkwy, Romeoville, IL 60446-1673 | 2005-09-26 |
1528681764 | Holon Inclusive Behavioral Health | Psychiatry & Neurology | 301 S Main St, Dupo, IL 62239-1325 | 2020-05-21 |
1013555416 | Mathers Recovery LLC | Psychiatry & Neurology | 81 E Grand Ave, Fox Lake, IL 60020-1557 | 2019-12-16 |
Find all providers with the same taxonomy |
City | PALOS HEIGHTS |
Zip Code | 60463 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.