Healthcare Provider Details

I. General information

NPI: 1629247523
Provider Name (Legal Business Name): JANET M HOFFMAN RD, LD, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 N ROCKTON AVE
ROCKFORD IL
61103-3655
US

IV. Provider business mailing address

2400 N ROCKTON AVE
ROCKFORD IL
61103-3655
US

V. Phone/Fax

Practice location:
  • Phone: 815-971-6712
  • Fax: 815-969-9590
Mailing address:
  • Phone: 815-971-6712
  • Fax: 815-969-9590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: