| Illinois Home Providers, Inc | |
|
540 W Frontage Rd 2117 Northfield IL 60093-1250 | |
| (224) 505-5907 | |
| (224) 255-6057 |
| Full Name | Illinois Home Providers, Inc |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 540 W Frontage Rd, Northfield, Illinois |
| Authorized Official Name and Position | Kimberly Ramirez-tasigchana (FNP-C/ PRESIDENT) |
| Authorized Official Contact | 2245055907 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Home Providers, Inc 540 W Frontage Rd 2117 Northfield IL 60093-1250 Ph: (224) 505-5907 | Illinois Home Providers, Inc 540 W Frontage Rd 2117 Northfield IL 60093-1250 Ph: (224) 505-5907 |
| NPI Number | 1972951192 |
|---|---|
| Provider Enumeration Date | 05/27/2016 |
| Last Update Date | 07/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972951192 | NPI | - | NPPES |
| 340766270001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Primary |
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