Healthcare Provider Details

I. General information

NPI: 1487702775
Provider Name (Legal Business Name): JOHN HOBBS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 06/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

736 W 95TH ST HALSTED MEDICAL CENTER
CHICAGO IL
60628-1063
US

IV. Provider business mailing address

736 W 95TH ST HALSTED MEDICAL CENTER
CHICAGO IL
60628-1063
US

V. Phone/Fax

Practice location:
  • Phone: 773-487-7700
  • Fax: 708-229-6077
Mailing address:
  • Phone: 773-487-7700
  • Fax: 708-229-6077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036054680
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: