MEDICARE: NP AT HOME

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1699191312
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NP AT HOME

Provider Business Mailing Address
First Line	:	7008 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3029
Country	:	US
Telephone Number	:	773-245-3222
Fax Number	:

Provider Business Practice Location Address
First Line	:	7008 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-3029
Country	:	US
Telephone Number	:	773-245-3222
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BRIAN WEINSTEIN
Credential	:	N.P.
Telephone Number	:	773-245-3222

Provider Enumeration Date	:	03/06/2014
Last Update Date	:	03/06/2014

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