Provider Demographics
NPI:1386181766
Name:ALL CARE HOME PHYSICIANS, S. C.
Entity Type:Organization
Organization Name:ALL CARE HOME PHYSICIANS, S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:847-410-7630
Mailing Address - Street 1:2713 NORMA CT
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60025-4660
Mailing Address - Country:US
Mailing Address - Phone:847-410-7630
Mailing Address - Fax:847-410-7631
Practice Address - Street 1:2713 NORMA CT
Practice Address - Street 2:
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60025-4660
Practice Address - Country:US
Practice Address - Phone:847-410-7630
Practice Address - Fax:847-410-7631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty