MEDICARE: DR. MICHAEL J HUSSEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VM0101X	Maternal & Fetal Medicine Physician	036075844	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	206147219	OTHER	IL	MEDICARE (INDIVIDUAL PTAN)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053395384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J HUSSEY MD

Provider Business Mailing Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1295
Country	:	US
Telephone Number	:	630-933-6091
Fax Number	:	630-933-2995

Provider Business Practice Location Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1295
Country	:	US
Telephone Number	:	630-933-6091
Fax Number	:	630-933-2995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	11/04/2024

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