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General NPI Number Information
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NPI Number | 1730899584
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Entity Type | Organization
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Legal Business Name | OASIS HOUSE CALL LLC
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Dates
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Enumeration Date | 12/02/2022
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 6965 W AIRE LIBRE AVE
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City | PEORIA
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State | AZ
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Zip | 85382-3987
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Country | US
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Telephone | 815-953-6422
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Fax |
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Provider Business Mailing Address
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Address Line | 8550 S HARLEM AVE STE G
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City | BRIDGEVIEW
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State | IL
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Zip | 60455-1775
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RAHUL DEEPANKER
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Credential | MD
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Telephone | 815-953-6422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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