Healthcare Provider Details

I. General information

NPI: 1649078957
Provider Name (Legal Business Name): JOHN PATRICK HILL MEDICAL STUDENT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: JACK HILL

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE STE 1304
EVANSTON IL
60201-1700
US

IV. Provider business mailing address

180 HARVESTER DR STE 110
BURR RIDGE IL
60527-6686
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-2000
  • Fax:
Mailing address:
  • Phone: 773-702-1150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: