Individual
ANDREW JAY HOTALING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S FIRST AVE, MAGUIRE CENTER 1870, MAYWOOD, IL 60153
(708) 216-9183
(708) 216-4834
Mailing address
2160 S FIRST AVE, MAGUIRE CENTER 1870, MAYWOOD, IL 60153
(708) 216-9183
(708) 216-4834
Taxonomy
Speciality
Code
Description
License number
State
207YP0228X
Pediatric Otolaryngology Physician
Primary
036-062122
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36062122
—
IL
Enumeration date
12/28/2005
Last updated
06/17/2011
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