Healthcare Provider Details

I. General information

NPI: 1457878506
Provider Name (Legal Business Name): ERIC MICHAEL HOFMANN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 S PARK ST
MADISON WI
53715-1830
US

IV. Provider business mailing address

920 S VAIL AVE
ARLINGTON HEIGHTS IL
60005-2542
US

V. Phone/Fax

Practice location:
  • Phone: 608-251-6100
  • Fax: 608-258-5222
Mailing address:
  • Phone: 309-251-9788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number8881-33
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number041369587
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: