Provider Demographics
NPI:1861814915
Name:SILOAM HOME AND WOUND CARE PHYSICIANS INC
Entity Type:Organization
Organization Name:SILOAM HOME AND WOUND CARE PHYSICIANS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:OFISI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-590-1601
Mailing Address - Street 1:1342 W GRENSHAW ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-0025
Mailing Address - Country:US
Mailing Address - Phone:312-590-1601
Mailing Address - Fax:
Practice Address - Street 1:1342 W GRENSHAW ST APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-0025
Practice Address - Country:US
Practice Address - Phone:312-590-1601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty