Provider Demographics
NPI:1548717697
Name:HOPE
Entity type:Organization
Organization Name:HOPE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMA
Authorized Official - Middle Name:R
Authorized Official - Last Name:DSILVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-640-1352
Mailing Address - Street 1:608 S NOAH TER
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-3556
Mailing Address - Country:US
Mailing Address - Phone:847-640-1352
Mailing Address - Fax:
Practice Address - Street 1:608 S NOAH TER
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-3556
Practice Address - Country:US
Practice Address - Phone:847-640-1352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0-662-507-3207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty