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General NPI Number Information
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NPI Number | 1538546148
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Entity Type | Organization
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Legal Business Name | ILLINOIS HOSPITALISTS, LLP
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Dates
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Enumeration Date | 05/04/2015
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 6800 STATE ROUTE 162
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City | MARYVILLE
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State | IL
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Zip | 62062-8500
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Country | US
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Telephone | 618-288-5711
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Fax |
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Provider Business Mailing Address
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Address Line | 75 REMIT DR # 1103
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City | CHICAGO
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State | IL
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Zip | 60675-1103
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Country | US
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Telephone | 800-210-7034
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DERIK K KING
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Credential | MD
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Telephone | 866-916-5259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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