MEDICARE: DR. TERESA A HUBKA D.O.

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	207V00000X	Obstetrics & Gynecology Physician	036086740	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	01621679	OTHER	IL	BCBS OF IL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659354140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TERESA A HUBKA D.O.

Provider Business Mailing Address
First Line	:	PO BOX 578220
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-7303
Country	:	US
Telephone Number	:	773-549-8900
Fax Number	:	773-549-8511

Provider Business Practice Location Address
First Line	:	3152 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3117
Country	:	US
Telephone Number	:	773-549-8900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2005
Last Update Date	:	11/01/2018

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