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Organization

ILLIANA HOME PHYSICIAN SERVICES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES BECKETT M.D. (MANAGER)
(773) 359-4757
Entity
Organization

Contact information

Practice address
1609 SIBLEY BLVD, CALUMET CITY, IL 60409-2217
(773) 359-4757
Mailing address
1609 SIBLEY BLVD, CALUMET CITY, IL 60409-2217
(773) 359-4757

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036087374
IL
332B00000X
Durable Medical Equipment & Medical Supplies
036087374
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036087374
IL
Enumeration date
07/31/2015
Last updated
02/19/2019
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