Provider Demographics
NPI:1972745107
Name:METRO HOME VISITING PHYSICIANS, LLC
Entity Type:Organization
Organization Name:METRO HOME VISITING PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:A
Authorized Official - Last Name:NKPE
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:773-556-3999
Mailing Address - Street 1:1240 IROQUOIS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8538
Mailing Address - Country:US
Mailing Address - Phone:773-556-3999
Mailing Address - Fax:630-416-2147
Practice Address - Street 1:1240 IROQUOIS AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8536
Practice Address - Country:US
Practice Address - Phone:630-416-0754
Practice Address - Fax:630-416-2147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health