Healthcare Provider Details

I. General information

NPI: 1164514030
Provider Name (Legal Business Name): ALEXANDER R. HOFFMAN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 12/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6157 N KILPATRICK AVE
CHICAGO IL
60646-5042
US

IV. Provider business mailing address

6157 N KILPATRICK AVE
CHICAGO IL
60646-5042
US

V. Phone/Fax

Practice location:
  • Phone: 773-841-2144
  • Fax:
Mailing address:
  • Phone: 773-841-2144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number051040456
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: