Healthcare Provider Details

I. General information

NPI: 1154424208
Provider Name (Legal Business Name): DONALD R HOFFMAN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 02/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16535 S 106TH CT
ORLAND PARK IL
60467
US

IV. Provider business mailing address

16535 S 106TH CT
ORLAND PARK IL
60467
US

V. Phone/Fax

Practice location:
  • Phone: 708-349-8888
  • Fax: 708-349-6873
Mailing address:
  • Phone: 708-349-8888
  • Fax: 708-349-6873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: