Provider Demographics
NPI:1932061868
Name:HOMETOWN NP IN PSYCHIATRY PLLC
Entity type:Organization
Organization Name:HOMETOWN NP IN PSYCHIATRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHIME
Authorized Official - Middle Name:
Authorized Official - Last Name:AJIERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-998-2979
Mailing Address - Street 1:10209 W LINCOLN HWY
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-1279
Mailing Address - Country:US
Mailing Address - Phone:708-998-2979
Mailing Address - Fax:708-273-5531
Practice Address - Street 1:418 BROADWAY STE N
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-2922
Practice Address - Country:US
Practice Address - Phone:708-998-2979
Practice Address - Fax:708-273-5531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty