Healthcare Provider Details

I. General information

NPI: 1902804628
Provider Name (Legal Business Name): JOHN G HOHNER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 05/16/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15300 WEST AVE STE 223
ORLAND PARK IL
60462-4509
US

IV. Provider business mailing address

15300 WEST AVE STE 223
ORLAND PARK IL
60462-4509
US

V. Phone/Fax

Practice location:
  • Phone: 708-226-2440
  • Fax: 708-923-7876
Mailing address:
  • Phone: 708-226-2440
  • Fax: 708-923-7876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036077800
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: