Simon A Holoubek, D.O.
Surgery in Rockford, IL. Individual provider (NPI-1).
NPI number1043697618
StatusActive
Last updated in NPPESMar 2, 2022
Details
- NPI
- 1043697618
- Entity type
- Individual (NPI-1)
- Name
- Simon A Holoubek
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 2, 2015
- Certification date
- Mar 2, 2022
- Last updated
- Mar 2, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | 036-157876 | IL | Yes |
| 207Y00000X | Otolaryngology | 85540 | GA | |
| 208600000X | Surgery | 76254 | WI | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1340 Charles St Ste 100&405Rockford, IL 61104-2200
Phone 779-696-8700
Mailing address
7974 Uw Health CtMiddleton, WI 53562-5531
Other practice locations
600 Highland Ave
Madison, WI 53792-1010
Madison, WI 53792-1010
Phone 608-263-7502 · Fax 608-263-7652
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