Provider Demographics
NPI:1598162190
Name:HOUSECALL DOCTORS PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:HOUSECALL DOCTORS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:A
Authorized Official - Last Name:KASSEM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-901-8000
Mailing Address - Street 1:5875 N LINCOLN AVE
Mailing Address - Street 2:STE#120
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4672
Mailing Address - Country:US
Mailing Address - Phone:773-901-8000
Mailing Address - Fax:773-944-9800
Practice Address - Street 1:5875 N LINCOLN AVE
Practice Address - Street 2:STE#120
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4672
Practice Address - Country:US
Practice Address - Phone:773-901-8000
Practice Address - Fax:773-944-9800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty