Healthcare Provider Details

I. General information

NPI: 1609450147
Provider Name (Legal Business Name): LINDA ANN HOZJAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1218 LACOMA DR
LOCKPORT IL
60441-3200
US

IV. Provider business mailing address

1218 LACOMA DR
LOCKPORT IL
60441-3200
US

V. Phone/Fax

Practice location:
  • Phone: 630-878-8291
  • Fax:
Mailing address:
  • Phone: 630-878-8291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: