Healthcare Provider Details

I. General information

NPI: 1346406014
Provider Name (Legal Business Name): JENNIFER J HOFHERR OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 W PALMER ST
CHICAGO IL
60647-3239
US

IV. Provider business mailing address

2236 W PALMER ST
CHICAGO IL
60647-3239
US

V. Phone/Fax

Practice location:
  • Phone: 773-384-5868
  • Fax:
Mailing address:
  • Phone: 773-384-5868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number560004490
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: