Provider Demographics
NPI:1497539969
Name:COMMUNITY VISITING PHYSICIANS LLC
Entity Type:Organization
Organization Name:COMMUNITY VISITING PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUQMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-473-7963
Mailing Address - Street 1:229 W GRAND AVE STE R
Mailing Address - Street 2:
Mailing Address - City:BENSENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60106-3365
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:229 W GRAND AVE STE R
Practice Address - Street 2:
Practice Address - City:BENSENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60106-3365
Practice Address - Country:US
Practice Address - Phone:630-473-7963
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty