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General NPI Number Information
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NPI Number | 1578665907
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Entity Type | Organization
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Legal Business Name | HOME HEALTH MEDICAL LLC
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 9900 SOUTHWEST HWY
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City | OAK LAWN
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State | IL
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Zip | 60453-3724
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Country | US
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Telephone | 708-422-7758
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Fax | 708-422-8154
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Provider Business Mailing Address
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Address Line | 9900 SOUTHWEST HWY
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City | OAK LAWN
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State | IL
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Zip | 60453-3724
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Country | US
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Telephone | 708-422-7758
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Fax | 708-422-8154
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Authorized Official
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Title or Position | SOLE MANAGER/PHYSICIAN
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Name | DR. RONALD ERIC SAM
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Credential | D.O.
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Telephone | 708-422-7758
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036094623
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License Number State | IL
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