Organization
HOME DOCTORS MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRISH P SRIRAM (MEMBER)
(847) 615-2273
Entity
Organization
Contact information
Practice address
611 HUNTER, LAKE FOREST, IL 60045-4905
(847) 615-2273
(877) 335-6195
Mailing address
611 HUNTER, LAKE FOREST, IL 60045-4905
(847) 615-2273
(877) 335-6195
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036088401
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036088401
IL
207RC0001X
Clinical Cardiac Electrophysiology Physician
036088401
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
036088401
IL
Other
Enumeration date
11/17/2010
Last updated
11/17/2010
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