Organization Name: | MEDPRO VASCULAR INSTITUTE |
NPI Number: | 1235598566 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBIN HOFFMAN (CEO/MEMBER) |
Mailing Address: | 472 Briargate Dr Unit 107 South Elgin |
State: | IL US |
Postal Code: | 601772225 |
Phone Number: | 2245358758 |
Fax Number: | |
NPI Enumeration Date: | 02/15/2016 |
NPI Last Update Date: | 02/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | 036117153 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |