Provider Demographics
NPI:1144693177
Name:COMMUNITY HOUSE CALL SERVICES LLC
Entity type:Organization
Organization Name:COMMUNITY HOUSE CALL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:REENU
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGHESE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:844-546-8732
Mailing Address - Street 1:905 JOLIET ST
Mailing Address - Street 2:
Mailing Address - City:DYER
Mailing Address - State:IN
Mailing Address - Zip Code:46311-1922
Mailing Address - Country:US
Mailing Address - Phone:844-546-8732
Mailing Address - Fax:708-529-2592
Practice Address - Street 1:905 JOLIET ST
Practice Address - Street 2:
Practice Address - City:DYER
Practice Address - State:IN
Practice Address - Zip Code:46311-1922
Practice Address - Country:US
Practice Address - Phone:844-546-8732
Practice Address - Fax:708-529-2592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-13
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.008515207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty