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Individual

ETHAN MOLITCH-HOU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-1000
Mailing address
150 HARVESTER DR STE 300, BURR RIDGE, IL 60527-5965
(773) 702-5957
(773) 702-0000

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125054504
IL
207R00000X
Internal Medicine Physician
ME118225
FL
208M00000X
Hospitalist Physician
Primary
036127854
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011157100
FL
01
P01366900
RR MEDICARE
FL
Enumeration date
07/03/2008
Last updated
02/19/2021
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