Provider Demographics
NPI:1346576055
Name:DOCS AT THE DOOR INC
Entity Type:Organization
Organization Name:DOCS AT THE DOOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXEC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AJIBOLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AYENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-362-3820
Mailing Address - Street 1:4747 LINCOLN MALL DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-3811
Mailing Address - Country:US
Mailing Address - Phone:708-332-9887
Mailing Address - Fax:708-503-0737
Practice Address - Street 1:4747 LINCOLN MALL DR
Practice Address - Street 2:SUITE 304
Practice Address - City:MATTESON
Practice Address - State:IL
Practice Address - Zip Code:60443-3811
Practice Address - Country:US
Practice Address - Phone:708-332-9887
Practice Address - Fax:708-503-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2009-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036077698253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care