Basic Information
| Provider Information | |||||||||
| NPI: | 1568909505 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY HOME PHYSICIANS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1S450 SUMMIT AVE STE 165 | ||||||||
| Address2: | |||||||||
| City: | OAKBROOK TERRACE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601813952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303206871 | ||||||||
| FaxNumber: | 6303850026 | ||||||||
| Practice Location | |||||||||
| Address1: | 1S450 SUMMIT AVE STE 165 | ||||||||
| Address2: | |||||||||
| City: | OAKBROOK TERRACE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601813952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303206871 | ||||||||
| FaxNumber: | 6303850026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/29/2017 | ||||||||
| LastUpdateDate: | 07/15/2022 | ||||||||
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| AuthorizedOfficialLastName: | ALMOSHELLI | ||||||||
| AuthorizedOfficialFirstName: | BADER | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6303206871 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | 07/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 208D00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 213E00000X | N | 193200000X MULTI-SPECIALTY GROUP | Podiatric Medicine & Surgery Service Providers | Podiatrist | 208100000X | 036-134581 | IL | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.