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Organization

HOPSCOTCH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BENJAMIN S YABUT JR. M.D. (MANAGING DIRECTOR)
(847) 844-1248
Entity
Organization

Contact information

Practice address
1141 E MAIN ST, SUITE 212, EAST DUNDEE, IL 60118-2440
(847) 844-1248
(847) 844-1287
Mailing address
PO BOX 3046, BARRINGTON, IL 60011-3046
(847) 844-1248
(847) 844-1287

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001635078
BLUE CROSS BLUE SHIELDS
IL
01
0007055591
AETNA
IL
05
036085422
IL
Enumeration date
05/27/2007
Last updated
05/08/2009
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