Individual
PAVEL HUDOBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 E ARMY TRAIL RD, SUITE 407, BLOOMINGDALE, IL 60108-2169
(630) 980-4922
(630) 980-4923
Mailing address
303 E ARMY TRAIL RD, SUITE 407, BLOOMINGDALE, IL 60108-2169
(630) 980-4922
(630) 980-4923
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02232241
BCBS PROVIDER NUMBER
IL
01
—
7566105
AETNA PROVIDER NUMBER
IL
01
—
8251421
CIGNA PROVIDER NUMBER
IL
01
—
P00188276
RAILROAD MEDICARE NUMBER
IL
Enumeration date
12/11/2006
Last updated
07/08/2007
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