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General NPI Number Information
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NPI Number | 1255665014
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Entity Type | Organization
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Legal Business Name | MARK HOOVER DC SC
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Dates
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Enumeration Date | 09/28/2009
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Last Update Date | 09/28/2009
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Provider Practice Location Address
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Address Line | 141 W JACKSON BLVD SUITE A 20
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City | CHICAGO
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State | IL
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Zip | 60604-2901
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Country | US
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Telephone | 312-939-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 141 W JACKSON BLVD SUITE A 20
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City | CHICAGO
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State | IL
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Zip | 60604-2901
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Country | US
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Telephone | 312-939-3400
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARK HOOVER
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Credential | DC
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Telephone | 847-452-2849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038.011435
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License Number State | IL
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