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General NPI Number Information
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NPI Number | 1134303019
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Entity Type | Organization
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Legal Business Name | HOPKINS MEDICAL GROUP INC
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 1550 W 88TH ST SUITE 310
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City | CHICAGO
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State | IL
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Zip | 60620-4828
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Country | US
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Telephone | 773-369-6264
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Fax | 708-897-0352
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Provider Business Mailing Address
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Address Line | 4426 S KING DR
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City | CHICAGO
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State | IL
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Zip | 60653-3348
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Country | US
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Telephone | 708-860-8650
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Fax | 708-897-0352
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Authorized Official
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Title or Position | PRESIDENT
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Name | KIRK HOPKINS
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Credential | MD
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Telephone | 708-860-8650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036111765
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License Number State | IL
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