Healthcare Provider Details

I. General information

NPI: 1780780965
Provider Name (Legal Business Name): WENDY J HOZMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 WEST END COURT SUITE 204
VERNON HILLS IL
60061
US

IV. Provider business mailing address

870 WEST END COURT SUITE 204
VERNON HILLS IL
60061
US

V. Phone/Fax

Practice location:
  • Phone: 847-367-4230
  • Fax: 847-367-4232
Mailing address:
  • Phone: 847-367-4230
  • Fax: 847-367-4232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: