Healthcare Provider Details

I. General information

NPI: 1962146571
Provider Name (Legal Business Name): HOMETOWN PRIMARY CARE OF FRANKFORT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2022
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10205 W LINCOLN HWY
FRANKFORT IL
60423-1279
US

IV. Provider business mailing address

10205 W LINCOLN HWY
FRANKFORT IL
60423-1279
US

V. Phone/Fax

Practice location:
  • Phone: 708-998-2979
  • Fax:
Mailing address:
  • Phone: 708-998-2979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CHIME AJIERE
Title or Position: CEO
Credential: APRN
Phone: 708-847-8688