Provider Demographics
NPI:1811740046
Name:YOUR HEALTHCARE SOURCE PLLC
Entity type:Organization
Organization Name:YOUR HEALTHCARE SOURCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMENAK
Authorized Official - Middle Name:
Authorized Official - Last Name:ASATRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-505-3010
Mailing Address - Street 1:448 MARGATE TER
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3359
Mailing Address - Country:US
Mailing Address - Phone:847-236-0323
Mailing Address - Fax:
Practice Address - Street 1:1366 S MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3795
Practice Address - Country:US
Practice Address - Phone:847-236-0323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care