Healthcare Provider Details
I. General information
NPI: 1548300395
Provider Name (Legal Business Name): MARC PETER HILGERS MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/08/2007
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1221 N HIGHLAND AVE
AURORA IL
60506-1404
US
IV. Provider business mailing address
29373 NETWORK PL
CHICAGO IL
60673-1293
US
V. Phone/Fax
- Phone: 630-859-8700
- Fax: 630-264-8423
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 01061202A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | ME 99969 |
| License Number State | FL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | ME99969 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QS0010X |
| Taxonomy | Sports Medicine (Family Medicine) Physician |
| License Number | 036137322 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: