Mso Illinois LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MSO ILLINOIS LLC

Doing business as

The HOME DOCTOR

Practice address

6400 W College Dr Ste 100
Palos Heights, IL 60463-1789

Phone

(253) 335-5150

Fax

(253) 984-1079

NPI assigned

Jul 12, 2024

Last updated

Jul 12, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Muahmmad Nazir

Title

Owner

Phone

(253) 335-5150

Specialties & licenses 1

Addresses

Other names 1

• The HOME DOCTOR Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Yesenia Bahena, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1194165118
  Medicare reassignment NPD
• Mehreen Maryam, NP

  • Adult Health Nurse Practitioner
  • Federal Way, WA
  • NPI 1467178319
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1568209880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 W COLLEGE DR STE 100",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631789",
            "telephone_number": "253-335-5150",
            "fax_number": "253-984-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 W COLLEGE DR STE 100",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631789",
            "telephone_number": "253-335-5150",
            "fax_number": "253-984-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSO ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "NAZIR",
        "authorized_official_first_name": "MUAHMMAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-335-5150"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The HOME DOCTOR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phillip F Morreale, DPM
• Margaret Ann Moss I, LCSW
• Kimberly Ann Moyer, LCPC
• Nicole Kelly Mozden, M.D.
• Jeffrey Allen Mozwecz, M.D.
• Dana Karen Mueller
• Jeffrey Scott Mulac, D.D.S.
• Donna Mulchrone
• Shelley Mulchrone, MRS.
• Kimberly A Mullin, MD

• Family Medicine Physician in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.