Provider Demographics
NPI:1285289421
Name:HOMER GLEN MEDICAL SERVICES CORP
Entity type:Organization
Organization Name:HOMER GLEN MEDICAL SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEGUNDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-818-8667
Mailing Address - Street 1:1550 E HIGGINS RD STE 130
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE VILLAGE
Mailing Address - State:IL
Mailing Address - Zip Code:60007-1627
Mailing Address - Country:US
Mailing Address - Phone:847-621-2932
Mailing Address - Fax:
Practice Address - Street 1:1550 E HIGGINS RD STE 130
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-1627
Practice Address - Country:US
Practice Address - Phone:847-621-2932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No251E00000XAgenciesHome Health