Organization
JOHN HOUSTON
Active
Other names
PEDIATRIC UROLOGY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOUSTON MD (OWNER)
(312) 632-0032
Entity
Organization
Contact information
Practice address
2308 N LINCOLN AVE, CHICAGO, IL 60614-3676
(312) 632-0032
(773) 409-5089
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634125
BCBS PROVIDER ID
IL
Enumeration date
11/01/2006
Last updated
01/11/2008
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