Provider Demographics
NPI:1144525510
Name:AMERICAN HOME VISITING PHYSICIANS
Entity type:Organization
Organization Name:AMERICAN HOME VISITING PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAINO
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:847-833-4560
Mailing Address - Street 1:PO BOX 578220
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-8121
Mailing Address - Country:US
Mailing Address - Phone:847-833-4560
Mailing Address - Fax:
Practice Address - Street 1:581 E GOLF RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-2349
Practice Address - Country:US
Practice Address - Phone:888-731-3141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty