Healthcare Provider Details

I. General information

NPI: 1568909505
Provider Name (Legal Business Name): COMMUNITY HOME PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2017
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1S450 SUMMIT AVE STE 165
OAKBROOK TERRACE IL
60181-3952
US

IV. Provider business mailing address

1S450 SUMMIT AVE STE 165
OAKBROOK TERRACE IL
60181-3952
US

V. Phone/Fax

Practice location:
  • Phone: 630-320-6871
  • Fax: 630-385-0026
Mailing address:
  • Phone: 630-320-6871
  • Fax: 630-385-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number036-134581
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: BADER ALMOSHELLI
Title or Position: OWNER
Credential: M.D.
Phone: 630-320-6871