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General NPI Number Information
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NPI Number | 1194826701
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Entity Type | Organization
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Legal Business Name | VER PHYSICIAN TO HOME SERVICES INC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/19/2007
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Provider Practice Location Address
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Address Line | 155 W SCHICK RD
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1243
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Country | US
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Telephone | 630-244-9554
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Fax | 630-351-0776
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Provider Business Mailing Address
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Address Line | 155 W SCHICK RD
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-1243
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Country | US
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Telephone | 630-244-9554
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Fax | 630-351-0776
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Authorized Official
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Title or Position | DIRECT OWNER
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Name | MRS. ANNALYN HIBO GAMBOA
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Credential |
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Telephone | 630-244-9554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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