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General NPI Number Information
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NPI Number | 1760086540
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Entity Type | Organization
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Legal Business Name | MIDWEST HOME PHYSICIANS INC
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1536 SAINT CLAIR AVE NE
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City | CLEVELAND
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State | OH
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Zip | 44114-2004
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Country | US
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Telephone | 216-243-9188
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Fax |
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Provider Business Mailing Address
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Address Line | 6421 N HAMLIN AVE # F
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City | LINCOLNWOOD
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State | IL
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Zip | 60712-4041
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Country | US
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Telephone | 773-645-1192
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | JAMES VILLAR
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Credential |
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Telephone | 773-645-1192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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