Healthcare Provider Details

I. General information

NPI: 1962319418
Provider Name (Legal Business Name): GUARDIAN HOME MD CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1159 WILMETTE AVE STE 240
WILMETTE IL
60091-2653
US

IV. Provider business mailing address

1159 WILMETTE AVE STE 240
WILMETTE IL
60091-2653
US

V. Phone/Fax

Practice location:
  • Phone: 847-804-6616
  • Fax: 847-920-5928
Mailing address:
  • Phone: 847-804-6616
  • Fax: 847-920-5928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: BASMA P ARAKIS
Title or Position: PRESIDENT
Credential:
Phone: 847-293-5652