Healthcare Provider Details

I. General information

NPI: 1619471364
Provider Name (Legal Business Name): HORACE RHODES HAMBRICK MD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2018
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E CHICAGO AVE
CHICAGO IL
60611-2991
US

IV. Provider business mailing address

875 N MICHIGAN AVE STE 1500
CHICAGO IL
60611-1803
US

V. Phone/Fax

Practice location:
  • Phone: 800-543-7362
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number036170771
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: