Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 036103008 | IL |
NPI | 1306876297 |
---|---|
Provider Name | Peter Hoepfner |
First Address | Des Plaines, IL 60016-2359 |
Second Address | Libertyville, IL 60048-3757 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 21/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H98430 | (02) |