Provider Demographics
NPI:1285605675
Name:MIDWEST FAMILY MEDICINE
Entity type:Organization
Organization Name:MIDWEST FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR., OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOMEDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-351-1027
Mailing Address - Street 1:170 S BLOOMINGDALE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1470
Mailing Address - Country:US
Mailing Address - Phone:630-351-1027
Mailing Address - Fax:630-351-1190
Practice Address - Street 1:170 S BLOOMINGDALE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1470
Practice Address - Country:US
Practice Address - Phone:630-351-1027
Practice Address - Fax:630-351-1190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-01
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility