Healthcare Provider Details

I. General information

NPI: 1912781485
Provider Name (Legal Business Name): DAVID D HOHLE CSB
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 E 13TH ST APT 2203
CHICAGO IL
60605-3261
US

IV. Provider business mailing address

233 E 13TH ST APT 2203
CHICAGO IL
60605-3261
US

V. Phone/Fax

Practice location:
  • Phone: 312-659-9525
  • Fax:
Mailing address:
  • Phone: 312-659-9525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374K00000X
TaxonomyReligious Nonmedical Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: