MEDICARE: DR. GEORGE TADEUSZ HODAKOWSKI M.D.

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	01045222A	IN
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	036078800	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1821098575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GEORGE TADEUSZ HODAKOWSKI M.D.

Provider Business Mailing Address
First Line	:	9500 BORMET DR STE 204
Second Line	:
City	:	MOKENA
State	:	IL
Zip	:	60448-8399
Country	:	US
Telephone Number	:	708-346-4044
Fax Number	:	708-346-3287

Provider Business Practice Location Address
First Line	:	120 N OAK ST
Second Line	:	2ND FLOOR, EAST WING
City	:	HINSDALE
State	:	IL
Zip	:	60521-3829
Country	:	US
Telephone Number	:	630-568-3882
Fax Number	:	630-568-3886

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	12/17/2021

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Directions to “ DR. GEORGE TADEUSZ HODAKOWSKI M.D.” Practice Location

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