Individual
JOHN THE BAPTIST HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2400 N ASHLAND AVE, SUITE 200, CHICAGO, IL 60614-2021
(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
208800000X
Urology Physician
036-100082
IL
2088P0231X
Pediatric Urology Physician
Primary
036100082
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634125
BCBS PROVIDER ID
IL
05
—
036100082
—
IL
05
—
100013160B
—
IN
Enumeration date
09/20/2005
Last updated
04/26/2021
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