Healthcare Provider Details

I. General information

NPI: 1811417728
Provider Name (Legal Business Name): MEGAN HOFFMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2017
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date: 01/14/2018
Reactivation Date: 07/09/2021

III. Provider practice location address

601 SKOKIE BLVD STE 301
NORTHBROOK IL
60062-2819
US

IV. Provider business mailing address

601 SKOKIE BLVD STE 307
NORTHBROOK IL
60062-2819
US

V. Phone/Fax

Practice location:
  • Phone: 847-768-6288
  • Fax:
Mailing address:
  • Phone: 847-686-2889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.019076
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: