Healthcare Provider Details

I. General information

NPI: 1184741456
Provider Name (Legal Business Name): HOFMAIER CHIROPRACTIC LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 E SAINT CHARLES RD SUITE D
VILLA PARK IL
60181-2440
US

IV. Provider business mailing address

507 E SAINT CHARLES RD SUITE D
VILLA PARK IL
60181-2440
US

V. Phone/Fax

Practice location:
  • Phone: 630-782-6279
  • Fax:
Mailing address:
  • Phone: 630-782-6279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number24254444
License Number StateIL

VIII. Authorized Official

Name: MARIA HOFMAIER
Title or Position: DOCTOR OF CHIROPRACTIC
Credential:
Phone: 630-782-6279