Healthcare Provider Details

I. General information

NPI: 1740584903
Provider Name (Legal Business Name): F LYN HOBSON PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 EXECUTIVE CT SUITE 5A
SOUTH BARRINGTON IL
60010-9550
US

IV. Provider business mailing address

6811 W RAVEN ST APT 1 SOUTH
CHICAGO IL
60631-2567
US

V. Phone/Fax

Practice location:
  • Phone: 847-277-7930
  • Fax: 847-277-7932
Mailing address:
  • Phone: 773-774-1599
  • Fax: 773-774-1597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.002645
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: