MEDICARE: US HOME CARE VISITING PHYSICIANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1396169348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	US HOME CARE VISITING PHYSICIANS

Provider Business Mailing Address
First Line	:	6832 W NORTH AVE
Second Line	:	UNIT#2A
City	:	CHICAGO
State	:	IL
Zip	:	60707-4430
Country	:	US
Telephone Number	:	708-654-5039
Fax Number	:

Provider Business Practice Location Address
First Line	:	6832 W NORTH AVE
Second Line	:	UNIT#2A
City	:	CHICAGO
State	:	IL
Zip	:	60707-4430
Country	:	US
Telephone Number	:	708-654-5039
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BENJAMIN GUZMAN JR.
Credential	:
Telephone Number	:	708-654-5039

Provider Enumeration Date	:	02/11/2014
Last Update Date	:	02/11/2014

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