Healthcare Provider Details

I. General information

NPI: 1285956748
Provider Name (Legal Business Name): HOBART MEDICAL SOLUTIONS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 12/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2646 HIGHWAY AVE STE 114
HIGHLAND IN
46322-1662
US

IV. Provider business mailing address

6124 N MILWAUKEE AVE STE 2
CHICAGO IL
60646-3820
US

V. Phone/Fax

Practice location:
  • Phone: 219-301-5210
  • Fax: 773-774-8101
Mailing address:
  • Phone: 224-636-3637
  • Fax: 773-774-8101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code247100000X
TaxonomyRadiologic Technologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ZAFER ALI KHAN
Title or Position: PRESIDENT
Credential:
Phone: 224-636-3637