Provider Demographics
NPI:1760575310
Name:AMERICAN HOME PHYSICIANS LLC
Entity Type:Organization
Organization Name:AMERICAN HOME PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:MIRZA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-744-7864
Mailing Address - Street 1:5962 N. LINCOLN AVE
Mailing Address - Street 2:SUITE NUMBER 3
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659
Mailing Address - Country:US
Mailing Address - Phone:773-744-7864
Mailing Address - Fax:
Practice Address - Street 1:5962 N. LINCOLN AVE
Practice Address - Street 2:SUITE NUMBER 3
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659
Practice Address - Country:US
Practice Address - Phone:773-744-7864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty