Provider Demographics
NPI:1720386873
Name:HOUSECALL PHYSICIAN SERVICES LLC
Entity Type:Organization
Organization Name:HOUSECALL PHYSICIAN SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VENKATESAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-631-6657
Mailing Address - Street 1:7513 GRANT ST
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-4418
Mailing Address - Country:US
Mailing Address - Phone:630-631-6657
Mailing Address - Fax:630-541-9070
Practice Address - Street 1:7513 GRANT ST
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4418
Practice Address - Country:US
Practice Address - Phone:630-631-6657
Practice Address - Fax:630-541-9070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036098250251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management