Provider Demographics
NPI:1841703584
Name:HOME PHYSICIANS OF ILLINOIS LLC
Entity type:Organization
Organization Name:HOME PHYSICIANS OF ILLINOIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANUARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BERING SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-806-8102
Mailing Address - Street 1:507 W WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-5817
Mailing Address - Country:US
Mailing Address - Phone:224-251-8149
Mailing Address - Fax:
Practice Address - Street 1:5940 W TOUHY AVE STE 195
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4638
Practice Address - Country:US
Practice Address - Phone:847-213-0599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-15
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty