MEDICARE: DR. ALFREDA HAMPTON 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	207V00000X	Obstetrics & Gynecology Physician		IL

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	:	1558362335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALFREDA HAMPTON MD

Provider Business Mailing Address
First Line	:	1933 S STATE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-1768
Country	:	US
Telephone Number	:	312-842-9900
Fax Number	:	312-842-9905

Provider Business Practice Location Address
First Line	:	1933 S STATE ST
Second Line	:	SUITE C
City	:	CHICAGO
State	:	IL
Zip	:	60616-1768
Country	:	US
Telephone Number	:	312-842-9900
Fax Number	:	312-842-9905

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

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	07/08/2007

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