Provider Demographics
NPI:1942413752
Name:HAUSER, JOSHUA MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MARK
Last Name:HAUSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:750 N LAKE SHORE DR
Mailing Address - Street 2:SUITE 601
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3152
Mailing Address - Country:US
Mailing Address - Phone:312-503-3478
Mailing Address - Fax:312-503-5868
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-503-3478
Practice Address - Fax:312-503-5868
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036098497207RH0002X
IL36-098497207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH46107Medicare UPIN