Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 038-011357 | IL |
NPI | 1356572564 |
---|---|
Provider Name | Dr. Josh Hover |
First Address | Skokie, IL 60077-2568 |
Second Address | Skokie, IL 60077-2568 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2009 |
Last Update Date | 05/08/2009 |