Healthcare Provider Details

I. General information

NPI: 1801865191
Provider Name (Legal Business Name): DAVID A HOFFMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 HALSTED ST SUITE 525
CHICAGO IL
60603-5902
US

IV. Provider business mailing address

3000 N HALSTED ST STE 525
CHICAGO IL
60657-9269
US

V. Phone/Fax

Practice location:
  • Phone: 773-433-3130
  • Fax: 773-433-3127
Mailing address:
  • Phone: 773-433-3130
  • Fax: 773-433-3127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036070934
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: