Provider Demographics
NPI:1598184863
Name:PODIATRY HOMECARE SC
Entity Type:Organization
Organization Name:PODIATRY HOMECARE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAJEED
Authorized Official - Middle Name:
Authorized Official - Last Name:SOHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:224-848-0237
Mailing Address - Street 1:2008 N PULASKI RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-3767
Mailing Address - Country:US
Mailing Address - Phone:224-848-0237
Mailing Address - Fax:888-668-6550
Practice Address - Street 1:24 WOOD OAKS DR
Practice Address - Street 2:
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1092
Practice Address - Country:US
Practice Address - Phone:224-848-0237
Practice Address - Fax:888-668-6550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004709213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty