Healthcare Provider Details
I. General information
NPI: 1023207917
Provider Name (Legal Business Name): HOBSON MEADOWS FAMILY MEDICINE S C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2007
Last Update Date: 07/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1888 BAY SCOTT CIR
NAPERVILLE IL
60540-1106
US
IV. Provider business mailing address
1888 BAY SCOTT CIR
NAPERVILLE IL
60540-1106
US
V. Phone/Fax
- Phone: 630-305-0010
- Fax: 630-305-0311
- Phone: 630-305-0010
- Fax: 630-305-0311
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
ROZNER
Title or Position: OWNER
Credential: MD
Phone: 630-305-0010