Individual
DR. GEORGE B. HOLMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1611 W. HARRISON, SUITE 400, CHICAGO, IL 60612
(312) 431-3400
(312) 986-0105
Mailing address
1 WESTBROOK CORPORATE CTR, #240, WESTCHESTER, IL 60154-5701
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
036084263
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036084263
—
IL
01
—
1633878
BCBS ILLINOIS
IL
01
—
207067
MEDICARE PTAN LOCALITY #16
IL
01
—
207073
MEDICARE PTAN LOCALITY #15
IL
01
—
4408127
AETNA
—
01
—
DA4902
RR MEDICARE PTAN NUMBER
IL
01
—
P00239374
RR MEDICARE PROVIDER NUMBER
IL
Enumeration date
01/11/2006
Last updated
09/18/2018
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