Healthcare Provider Details

I. General information

NPI: 1871511196
Provider Name (Legal Business Name): JAMES H HLAVACEK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JAMES HLAVACEK MD

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MID AMERICA PLZ SUIE 720
OAKBROOK TERRACE IL
60181-4451
US

IV. Provider business mailing address

2001 BUTTERFIELD RD STE 300
DOWNERS GROVE IL
60515-1050
US

V. Phone/Fax

Practice location:
  • Phone: 630-571-0055
  • Fax: 630-571-1335
Mailing address:
  • Phone: 630-725-2700
  • Fax: 630-725-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036-060125
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036060125
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036060125
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number036060125
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: