Provider Demographics
NPI:1215483391
Name:AL HOMSSI, AMER (MD)
Entity type:Individual
Prefix:
First Name:AMER
Middle Name:
Last Name:AL HOMSSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10604 SOUTHWEST HWY STE 200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60415-2717
Mailing Address - Country:US
Mailing Address - Phone:708-634-4644
Mailing Address - Fax:708-634-4715
Practice Address - Street 1:10604 SOUTHWEST HWY STE 200
Practice Address - Street 2:
Practice Address - City:CHICAGO RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60415-2717
Practice Address - Country:US
Practice Address - Phone:708-634-4644
Practice Address - Fax:708-634-4715
Is Sole Proprietor?:No
Enumeration Date:2016-08-29
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71671207R00000X
IL036.148318207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1215483391Medicaid