Provider Demographics
NPI:1194330977
Name:HOME DOCTORS FOR YOU
Entity type:Organization
Organization Name:HOME DOCTORS FOR YOU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:REVITA
Authorized Official - Last Name:RUNEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-201-2389
Mailing Address - Street 1:7331 N LINCOLN AVE STE 15
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1766
Mailing Address - Country:US
Mailing Address - Phone:847-983-8356
Mailing Address - Fax:224-251-8156
Practice Address - Street 1:670 ILLINOIS BLVD
Practice Address - Street 2:
Practice Address - City:HOFFMAN EST
Practice Address - State:IL
Practice Address - Zip Code:60169-3363
Practice Address - Country:US
Practice Address - Phone:224-201-2389
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty