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General NPI Number Information
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NPI Number | 1306831938
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Entity Type | Individual
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Provider Name | JOHN THE BAPTIST HOUSTON MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 2400 N ASHLAND AVE SUITE 200
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City | CHICAGO
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State | IL
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Zip | 60614-2021
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Country | US
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Telephone | 312-632-0032
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Fax | 773-409-5089
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Provider Business Mailing Address
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Address Line | 777 OAKMONT LN SUITE 1600
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City | WESTMONT
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State | IL
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Zip | 60559-5511
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Country | US
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Telephone | 630-789-2550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036-100082
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2088P0231X
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Taxonomy Name | Pediatric Urology Physician
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License Number | 036100082
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License Number State | IL
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