Provider Demographics
NPI:1306258876
Name:HOSKINS, AMALIA (PBT)
Entity type:Individual
Prefix:
First Name:AMALIA
Middle Name:
Last Name:HOSKINS
Suffix:
Gender:F
Credentials:PBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7120 W 114TH ST
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-2039
Mailing Address - Country:US
Mailing Address - Phone:708-577-3206
Mailing Address - Fax:708-586-2221
Practice Address - Street 1:7120 W 114TH ST
Practice Address - Street 2:
Practice Address - City:WORTH
Practice Address - State:IL
Practice Address - Zip Code:60482-2039
Practice Address - Country:US
Practice Address - Phone:708-577-3206
Practice Address - Fax:708-586-2221
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor