Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 036145024 | IL |
NPI | 1043500887 |
---|---|
Provider Name | Amy Hoyme |
First Address | Lake In The Hills, IL 60156-4934 |
Second Address | Aurora, IL 60504-7222 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2011 |
Last Update Date | 25/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036145024 | (05) | IL |