Individual
IMELDA HOMECGOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1155 W JEFFERSON ST, SHOREWOOD, IL 60404-0701
(815) 741-5023
Mailing address
1155 W JEFFERSON ST, SHOREWOOD, IL 60404-0701
(815) 741-5203
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.013686
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209.013686
LICENSE NUMBER
IL
Enumeration date
01/05/2016
Last updated
03/10/2026
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