Provider Demographics
NPI:1811310956
Name:HOMSI PEDIATRIC NEUROLOGY INC.
Entity type:Organization
Organization Name:HOMSI PEDIATRIC NEUROLOGY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOMSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-888-0751
Mailing Address - Street 1:4 NANDINA CT
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-2121
Mailing Address - Country:US
Mailing Address - Phone:630-771-0255
Mailing Address - Fax:630-771-0255
Practice Address - Street 1:4 NANDINA CT
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-2121
Practice Address - Country:US
Practice Address - Phone:630-771-0255
Practice Address - Fax:630-771-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-25
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036112318261QM2500X
208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty