Organization
PHYSICIAN AT HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KHURRAM KHAN (MANAGER)
(708) 444-0484
Entity
Organization
Contact information
Practice address
16650 HARLEM AVE STE 1, TINLEY PARK, IL 60477-1847
(708) 444-0484
(708) 444-0485
Mailing address
16650 HARLEM AVE STE 1, TINLEY PARK, IL 60477-1847
(708) 444-0484
(708) 444-0485
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
IL
Other
Enumeration date
09/02/2010
Last updated
01/14/2011
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