Individual
JOHNNY HULBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 S 5TH AVE, HINES, IL 60141-3030
(708) 202-8387
Mailing address
EDWARD HINES JR VA HOSPITAL, 5000 S 5TH AVENUE, HINES, IL 60141
Taxonomy
Speciality
Code
Description
License number
State
226300000X
Kinesiotherapist
Primary
2062
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
VA
IL
Enumeration date
03/16/2020
Last updated
03/16/2020
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