Healthcare Provider Details

I. General information

NPI: 1942133046
Provider Name (Legal Business Name): MRS. BETHANY JEAN HOFF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 WESTPORT DR
ROCKTON IL
61072-2977
US

IV. Provider business mailing address

657 WESTPORT DR
ROCKTON IL
61072-2977
US

V. Phone/Fax

Practice location:
  • Phone: 815-985-4595
  • Fax: 815-985-4595
Mailing address:
  • Phone: 815-985-4595
  • Fax: 815-985-4595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number056.002713
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: