Healthcare Provider Details

I. General information

NPI: 1801120852
Provider Name (Legal Business Name): HOMETECH THERAPIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2009
Last Update Date: 03/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 WILEY RD SUITE 149
SCHAUMBURG IL
60173-4382
US

IV. Provider business mailing address

1365 WILEY RD SUITE 149
SCHAUMBURG IL
60173-4382
US

V. Phone/Fax

Practice location:
  • Phone: 847-884-8900
  • Fax: 847-884-8902
Mailing address:
  • Phone: 847-884-8900
  • Fax: 847-884-8902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number1011350
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number054016750
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number054016750
License Number StateIL

VIII. Authorized Official

Name: MR. KAM GHAZVINI
Title or Position: VP OF OPERATIONS
Credential: RPH
Phone: 847-884-8900