Provider Demographics
NPI:1285989160
Name:HOUSE CALLS OF GREATER CHICAGOLAND
Entity type:Organization
Organization Name:HOUSE CALLS OF GREATER CHICAGOLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-699-0293
Mailing Address - Street 1:8539 S SAGINAW AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-2444
Mailing Address - Country:US
Mailing Address - Phone:773-629-6036
Mailing Address - Fax:
Practice Address - Street 1:8836 S ASHLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-4956
Practice Address - Country:US
Practice Address - Phone:773-629-6036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100667207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty