Active NPI
Pavel Hudoba, M.D.
- Physical Medicine & Rehabilitation Physician
- Bloomingdale, IL
National Provider Identifier
1720148810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- Practice address
- 303 E Army Trail Rd
Suite 407
Bloomingdale, IL 60108-2169 - Phone
- (630) 980-4922
- Fax
- (630) 980-4923
- NPI assigned
- Dec 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | IL | Primary |
Addresses
Primary practice location
303 E Army Trail Rd
Suite 407
Bloomingdale, IL 60108-2169
Mailing address
303 E Army Trail Rd
Suite 407
Bloomingdale, IL 60108-2169
Phone (630) 980-4922
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7566105 | Other | IL | AETNA PROVIDER NUMBER |
| 02232241 | Other | IL | BCBS PROVIDER NUMBER |
| 8251421 | Other | IL | CIGNA PROVIDER NUMBER |
| P00188276 | Other | IL | RAILROAD MEDICARE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036097315 | IL | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720148810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 E ARMY TRAIL RD",
"address_2": "SUITE 407",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082169",
"telephone_number": "630-980-4922",
"fax_number": "630-980-4923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 E ARMY TRAIL RD",
"address_2": "SUITE 407",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601082169",
"telephone_number": "630-980-4922",
"fax_number": "630-980-4923"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDOBA",
"first_name": "PAVEL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "7566105",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "02232241",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER NUMBER",
"identifier": "8251421",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE NUMBER",
"identifier": "P00188276",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.