Healthcare Provider Details

I. General information

NPI: 1386194728
Provider Name (Legal Business Name): NICOLE HOHMANN MS,DIPL.OM,L.AC,FABO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 SHERMAN AVE
EVANSTON IL
60201-4421
US

IV. Provider business mailing address

1565 SHERMAN AVE
EVANSTON IL
60201-4421
US

V. Phone/Fax

Practice location:
  • Phone: 847-217-3505
  • Fax:
Mailing address:
  • Phone: 847-217-3505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number198000325
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: