Healthcare Provider Details

I. General information

NPI: 1487903092
Provider Name (Legal Business Name): HORIZONS IN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 RED BUD CT.
FRANKFORT IL
60423-2128
US

IV. Provider business mailing address

372 RED BUD CT.
FRANKFORT IL
60423-2128
US

V. Phone/Fax

Practice location:
  • Phone: 708-710-6048
  • Fax: 815-464-1984
Mailing address:
  • Phone: 708-710-6048
  • Fax: 815-464-1984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036071444
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number036071444
License Number StateIL

VIII. Authorized Official

Name: DR. MARK LUBIENSKI
Title or Position: MANAGER/OWNER
Credential: M.D.
Phone: 708-710-6048