Healthcare Provider Details

I. General information

NPI: 1255254934
Provider Name (Legal Business Name): ERIC HOFSTETTER LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 N WESTERN AVE APT 404
CHICAGO IL
60622-2416
US

IV. Provider business mailing address

1509 N WESTERN AVE APT 404
CHICAGO IL
60622-2416
US

V. Phone/Fax

Practice location:
  • Phone: 312-722-7444
  • Fax:
Mailing address:
  • Phone: 312-722-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.023185
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: