Provider Demographics
NPI:1427034073
Name:HOMEDI, EYAD (MD)
Entity Type:Individual
Prefix:DR
First Name:EYAD
Middle Name:
Last Name:HOMEDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 S BLOOMINGDALE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1470
Mailing Address - Country:US
Mailing Address - Phone:630-351-1027
Mailing Address - Fax:630-351-1190
Practice Address - Street 1:33 S VILLA AVE STE 2
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-2640
Practice Address - Country:US
Practice Address - Phone:630-832-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36100992207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
L89757Medicare PIN