Physician Compare National (NPI:1720148810)

HEALTHCARE PROVIDER: PAVEL HUDOBA M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1720148810
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991883498
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080424000271
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HUDOBA
	Individual professional last name
Provider First Name	PAVEL
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	303 E ARMY TRAIL RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 407
	Group Practice or individual's line 2 address
City	BLOOMINGDALE
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	601082155
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140292
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVENTIST GLENOAKS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y