Provider Demographics
| NPI: | 1851778146 |
|---|---|
| Name: | HOME MOBILITY SOLUTIONS, INC |
| Entity type: | Organization |
| Organization Name: | HOME MOBILITY SOLUTIONS, INC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MIKE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | CLEARY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 630-399-6137 |
| Mailing Address - Street 1: | 5239 THATCHER RD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | DOWNERS GROVE |
| Mailing Address - State: | IL |
| Mailing Address - Zip Code: | 60515-4027 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 630-399-6137 |
| Mailing Address - Fax: | 630-541-6903 |
| Practice Address - Street 1: | 5239 THATCHER RD |
| Practice Address - Street 2: | |
| Practice Address - City: | DOWNERS GROVE |
| Practice Address - State: | IL |
| Practice Address - Zip Code: | 60515-4027 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 630-399-6137 |
| Practice Address - Fax: | 630-541-6903 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2015-05-06 |
| Last Update Date: | 2015-05-06 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| IL | 1639193329 | Medicaid |