Provider Demographics
NPI:1881035673
Name:MEDICAL HOME NURSING INC.
Entity Type:Organization
Organization Name:MEDICAL HOME NURSING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER / ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEKSANDR
Authorized Official - Middle Name:D
Authorized Official - Last Name:VAYSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:8479221795
Authorized Official - Phone:847-922-1795
Mailing Address - Street 1:14570 W MAYLAND VILLA RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-2129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14570 W MAYLAND VILLA RD
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-2129
Practice Address - Country:US
Practice Address - Phone:847-922-1795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1011558251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health