Provider Demographics
NPI:1346739695
Name:CHICAGO HOME PHYSICIANS INC
Entity Type:Organization
Organization Name:CHICAGO HOME PHYSICIANS INC
Other - Org Name:CHICAGO DIAGNOSTIC SERVICES INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LODHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-997-4590
Mailing Address - Street 1:5234 LEE ST
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2166
Mailing Address - Country:US
Mailing Address - Phone:773-997-4590
Mailing Address - Fax:
Practice Address - Street 1:5234 LEE ST
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-2166
Practice Address - Country:US
Practice Address - Phone:773-997-4590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty