Individual
MITCHELL TIMOTHY HUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(708) 283-5500
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-170652
IL
207P00000X
Emergency Medicine Physician
4351044841
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2019
Last updated
10/22/2024
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