Healthcare Provider Details

I. General information

NPI: 1255727129
Provider Name (Legal Business Name): JANAE HOHBEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 04/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 W TAYLOR ST
CHICAGO IL
60612-7232
US

IV. Provider business mailing address

4867 N WINTHROP AVE APT 2
CHICAGO IL
60640-3605
US

V. Phone/Fax

Practice location:
  • Phone: 866-600-2273
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number25MB10250800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: