Provider Demographics
NPI:1417235359
Name:HOME PHYSICIANS 2011, PC
Entity Type:Organization
Organization Name:HOME PHYSICIANS 2011, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZATION
Authorized Official - Prefix:
Authorized Official - First Name:ROBYN
Authorized Official - Middle Name:CHANTELL
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-262-2739
Mailing Address - Street 1:730 COOL SPRINGS BLVD STE 500
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-7331
Mailing Address - Country:US
Mailing Address - Phone:773-292-4800
Mailing Address - Fax:312-564-4059
Practice Address - Street 1:525 W MONROE ST STE 1650
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-3647
Practice Address - Country:US
Practice Address - Phone:773-292-4800
Practice Address - Fax:312-564-4059
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOME PHYSICIANS 2011 PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-26
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty