Provider Demographics
NPI:1801026232
Name:HOMEBOUND VISITING DOCTORS INC
Entity Type:Organization
Organization Name:HOMEBOUND VISITING DOCTORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:ECHEVARRIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-269-8397
Mailing Address - Street 1:6601 S CASS AVE
Mailing Address - Street 2:UNIT E
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-3254
Mailing Address - Country:US
Mailing Address - Phone:216-269-8397
Mailing Address - Fax:630-241-3163
Practice Address - Street 1:6601 S CASS AVE
Practice Address - Street 2:UNIT E
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-3254
Practice Address - Country:US
Practice Address - Phone:216-269-8397
Practice Address - Fax:630-241-3163
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH036.122302208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty