# HOME PHYSICIANS 2011, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HOME PHYSICIANS 2011 PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417235359
- **Legal business name:** HOME PHYSICIANS 2011 PC
- **Authorized official:** GRACE BLUE (CREDENTIALING SR. MANAGER)
- **Authorized official phone:** (773) 292-4800

## Contact information

- **Practice address:** 525 W MONROE ST STE 1650, CHICAGO, IL 60661-3647
- **Practice address phone:** (773) 292-4800
- **Practice address fax:** (312) 564-4059
- **Mailing address:** 730 COOL SPRINGS BLVD STE 500, FRANKLIN, TN 37067-7331
- **Mailing address phone:** (773) 292-4800
- **Mailing address fax:** (312) 564-4059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/26/2011
- **Last updated:** 03/20/2025