Healthcare Provider Details

I. General information

NPI: 1639314768
Provider Name (Legal Business Name): WILLIAM S. HOHMAN R.N.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 S. 5TH AVE
HINES IL
60141-3030
US

IV. Provider business mailing address

5000 S. 5TH AVE
HINES IL
60141-3030
US

V. Phone/Fax

Practice location:
  • Phone: 708-202-7379
  • Fax:
Mailing address:
  • Phone: 708-202-7379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041-223975
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: