Provider Demographics
NPI:1194826701
Name:VER PHYSICIAN TO HOME SERVICES INC
Entity Type:Organization
Organization Name:VER PHYSICIAN TO HOME SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNALYN
Authorized Official - Middle Name:HIBO
Authorized Official - Last Name:GAMBOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-244-9554
Mailing Address - Street 1:155 W SCHICK RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1243
Mailing Address - Country:US
Mailing Address - Phone:630-244-9554
Mailing Address - Fax:630-351-0776
Practice Address - Street 1:155 W SCHICK RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1243
Practice Address - Country:US
Practice Address - Phone:630-244-9554
Practice Address - Fax:630-351-0776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health