| Illiana Home Physician Services Inc | |
|
1609 Sibley Blvd Calumet City IL 60409-2217 | |
| (773) 359-4757 | |
| Not Available |
| Full Name | Illiana Home Physician Services Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1609 Sibley Blvd, Calumet City, Illinois |
| Authorized Official Name and Position | James Beckett (MANAGER) |
| Authorized Official Contact | 7733594757 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illiana Home Physician Services Inc 1609 Sibley Blvd Calumet City IL 60409-2217 Ph: (773) 359-4757 | Illiana Home Physician Services Inc 1609 Sibley Blvd Calumet City IL 60409-2217 Ph: (773) 359-4757 |
| NPI Number | 1508242629 |
|---|---|
| Provider Enumeration Date | 07/31/2015 |
| Last Update Date | 02/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508242629 | NPI | - | NPPES |
| 036087374 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036087374 (Illinois) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 036087374 (Illinois) | Secondary |
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