Provider Demographics
NPI:1659308237
Name:HOZMAN, ROBERT A (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:HOZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 97
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-0097
Mailing Address - Country:US
Mailing Address - Phone:847-673-8473
Mailing Address - Fax:847-673-8470
Practice Address - Street 1:4709 GOLF RD
Practice Address - Street 2:SUITE 111
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1231
Practice Address - Country:US
Practice Address - Phone:847-673-8473
Practice Address - Fax:847-673-8470
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036067290207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01622311OtherBLUE SHIELD
IL110184190OtherRAILROAD MEDICARE
IL036067290Medicaid
IL453470Medicare PIN
IL01622311OtherBLUE SHIELD
C43280Medicare UPIN