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Organization

HOME MD LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESUS RENE DADIVAS M.D. (PRESIDENT)
(773) 772-8770
Entity
Organization

Contact information

Practice address
3426 W ARMITAGE AVE, CHICAGO, IL 60647-3720
(773) 772-8770
(847) 307-8314
Mailing address
3426 W ARMITAGE AVE, CHICAGO, IL 60647-3720
(773) 772-8770
(847) 307-8314

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
IL

Other

Enumeration date
08/10/2006
Last updated
08/22/2020
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