Healthcare Provider Details

I. General information

NPI: 1811740046
Provider Name (Legal Business Name): YOUR HEALTHCARE SOURCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1366 S MILWAUKEE AVE
LIBERTYVILLE IL
60048-3795
US

IV. Provider business mailing address

448 MARGATE TER
DEERFIELD IL
60015-3359
US

V. Phone/Fax

Practice location:
  • Phone: 847-236-0323
  • Fax:
Mailing address:
  • Phone: 847-236-0323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ARMENAK ASATRYAN
Title or Position: CEO
Credential: MD
Phone: 847-236-0323