Provider Demographics
NPI:1568709376
Name:PRECIOUS HOME FOOT CARE INC
Entity Type:Organization
Organization Name:PRECIOUS HOME FOOT CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GHADA
Authorized Official - Middle Name:
Authorized Official - Last Name:OMARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-468-8251
Mailing Address - Street 1:7255 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-1821
Mailing Address - Country:US
Mailing Address - Phone:708-468-8251
Mailing Address - Fax:708-468-8255
Practice Address - Street 1:7255 W 87TH ST
Practice Address - Street 2:
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455-1821
Practice Address - Country:US
Practice Address - Phone:708-468-8251
Practice Address - Fax:708-468-8255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016005387213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty