Healthcare Provider Details

I. General information

NPI: 1851728802
Provider Name (Legal Business Name): CARING DOCTOR AT HOME LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2013
Last Update Date: 10/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 S ROSELLE RD 2ND FLOOR
SCHAUMBURG IL
60193-3175
US

IV. Provider business mailing address

3727 ALBERT LN
LONG GROVE IL
60047-5228
US

V. Phone/Fax

Practice location:
  • Phone: 773-644-5681
  • Fax: 773-628-7532
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036111693
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number036111693
License Number StateIL

VIII. Authorized Official

Name: YANBING LAURA LI
Title or Position: OWNER
Credential: M.D.
Phone: 847-550-1236