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General NPI Number Information
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NPI Number | 1992905426
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Entity Type | Organization
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Legal Business Name | TIMOTHY C HAIN, MD, PC
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 645 N MICHIGAN AVE SUITE 410
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City | CHICAGO
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State | IL
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Zip | 60611-2826
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Country | US
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Telephone | 312-274-0197
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Fax | 312-274-0198
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Provider Business Mailing Address
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Address Line | PO BOX 11192
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City | CHICAGO
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State | IL
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Zip | 60611-0192
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Country | US
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Telephone | 312-274-0197
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Fax | 312-274-0198
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY C HAIN
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Credential | MD
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Telephone | 312-274-0197
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0901X
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Taxonomy Name | Otology & Neurotology Physician
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License Number |
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License Number State | IL
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