MEDICARE: YOUR HEALTHCARE SOURCE PLLC

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	261QM1300X	Multi-Specialty Clinic/Center
2	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1811740046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YOUR HEALTHCARE SOURCE PLLC

Provider Business Mailing Address
First Line	:	448 MARGATE TER
Second Line	:
City	:	DEERFIELD
State	:	IL
Zip	:	60015-3359
Country	:	US
Telephone Number	:	847-236-0323
Fax Number	:

Provider Business Practice Location Address
First Line	:	1366 S MILWAUKEE AVE
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-3795
Country	:	US
Telephone Number	:	847-236-0323
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ARMENAK ASATRYAN
Credential	:	MD
Telephone Number	:	847-236-0323

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	12/09/2025

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Directions to “YOUR HEALTHCARE SOURCE PLLC ” Practice Location

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