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NPI Code Detail

MEDICARE: COURTNEY HOLLOWELL MD

MEDICARE: COURTNEY HOLLOWELL MD
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
1208800000XUrology Physician036103721IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1K26426OTHERILPIN#

General Provider Information

NPI Number : 1326057712
Entity Type Code : Individual
Provider Name (Legal Business Name) : COURTNEY HOLLOWELL MD
Provider Business Mailing Address
First Line : 1616 S INDIANA AVE UNIT B4
Second Line :
City : CHICAGO
State : IL
Zip : 60616-1376
Country : US
Telephone Number : 312-864-5233
Fax Number : 312-864-9638
Provider Business Practice Location Address
First Line : 1901 W HARRISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3714
Country : US
Telephone Number : 312-864-5233
Fax Number : 312-864-9638
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 04/26/2021

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Directions to “ COURTNEY HOLLOWELL MD” Practice Location

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