Organization
OB-GYNE ASSOCIATES OF LAKE FOREST, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J HUBBELL M.D. (PRESIDENT)
(847) 234-3250
Entity
Organization
Contact information
Practice address
959 S. WAUKEGAN RD, FLOOR 2, LAKE FOREST, IL 60045
(847) 234-3250
(847) 234-8155
Mailing address
959 S. WAUKESAN RD, FLOOR 2, LAKE FOREST, IL 60045
(847) 234-3250
(847) 234-8155
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
042001387 036084828
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036067565
—
IL
05
—
036084302
—
IL
05
—
036092828
—
IL
05
—
036103613
—
IL
01
—
04915672
BCBS
—
01
—
CF6069
RAILROAD MEDICARE
IL
Enumeration date
01/30/2007
Last updated
03/02/2015
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