Healthcare Provider Details

I. General information

NPI: 1023150844
Provider Name (Legal Business Name): SHEENA L HOFFMANN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 01/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 N MICHIGAN AVE STE 1040
CHICAGO IL
60601-7421
US

IV. Provider business mailing address

180 N MICHIGAN AVE STE 1040
CHICAGO IL
60601-7421
US

V. Phone/Fax

Practice location:
  • Phone: 773-669-7829
  • Fax:
Mailing address:
  • Phone: 773-669-7829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071008418
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: