Provider Demographics
NPI:1710952569
Name:HOOVER, STANLEY V (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:V
Last Name:HOOVER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1730 PARK ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2688
Mailing Address - Country:US
Mailing Address - Phone:630-718-0200
Mailing Address - Fax:630-718-0900
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:GALTER PAVILLION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-2520
Practice Address - Fax:312-926-6524
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2010-08-10
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Provider Licenses
StateLicense IDTaxonomies
IL0360414172085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036041417Medicaid
IL036041417Medicaid