MEDICARE: HOMETOWN PRIMARY CARE OF FRANKFORT PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	363A00000X	Physician Assistant
3	101YM0800X	Mental Health Counselor
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962146571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMETOWN PRIMARY CARE OF FRANKFORT PLLC

Provider Business Mailing Address
First Line	:	10205 W LINCOLN HWY
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-1279
Country	:	US
Telephone Number	:	708-998-2979
Fax Number	:

Provider Business Practice Location Address
First Line	:	10205 W LINCOLN HWY
Second Line	:
City	:	FRANKFORT
State	:	IL
Zip	:	60423-1279
Country	:	US
Telephone Number	:	708-998-2979
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHIME AJIERE
Credential	:	APRN
Telephone Number	:	708-847-8688

Provider Enumeration Date	:	04/21/2022
Last Update Date	:	03/25/2026

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