Healthcare Provider Details

I. General information

NPI: 1316036114
Provider Name (Legal Business Name): WILLIAM MICHAEL HOPKINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 W 95TH ST STE 413
OAK LAWN IL
60453
US

IV. Provider business mailing address

4400 WEST 95TH ST STE 413
OAK LAWN IL
60453
US

V. Phone/Fax

Practice location:
  • Phone: 708-346-4055
  • Fax: 708-499-0948
Mailing address:
  • Phone: 708-346-4055
  • Fax: 708-499-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number36055519
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: