Healthcare Provider Details

I. General information

NPI: 1750404174
Provider Name (Legal Business Name): MICHAEL BRUCE HOFFMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N. MICHIGAN AVE. SUITE 1520
CHICAGO IL
60611-3758
US

IV. Provider business mailing address

500 N. MICHIGAN AVE. SUITE 1520
CHICAGO IL
60611-3758
US

V. Phone/Fax

Practice location:
  • Phone: 312-321-9486
  • Fax: 312-467-9534
Mailing address:
  • Phone: 312-321-9486
  • Fax: 312-467-9534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number36-43309
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number36-43309
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: