Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 19A13136 | IL |
Y | 213EG0000X | General Practice | 19A13136 | IL |
NPI | 1003067737 |
---|---|
Provider Name | Dr. Robert J Hodur |
First Address | Glenview, IL 60025-2910 |
Second Address | Glenview, IL 60025-2910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2008 |
Last Update Date | 30/09/2008 |