Provider Demographics
NPI:1801120852
Name:HOMETECH THERAPIES INC
Entity type:Organization
Organization Name:HOMETECH THERAPIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:KAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAZVINI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:847-884-8900
Mailing Address - Street 1:1365 WILEY RD
Mailing Address - Street 2:SUITE 149
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4382
Mailing Address - Country:US
Mailing Address - Phone:847-884-8900
Mailing Address - Fax:847-884-8902
Practice Address - Street 1:1365 WILEY RD
Practice Address - Street 2:SUITE 149
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4382
Practice Address - Country:US
Practice Address - Phone:847-884-8900
Practice Address - Fax:847-884-8902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-23
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0540167503336H0001X, 333600000X
IL1011350313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6461210001Medicare NSC