MEDICARE: CRISTINA HOFMAN PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	070015452	IL

General Provider Information

NPI Number	:	1417019878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTINA HOFMAN PT

Provider Business Mailing Address
First Line	:	7447 W TALCOTT AVE STE 501
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3716
Country	:	US
Telephone Number	:	773-631-7898
Fax Number	:	773-594-4113

Provider Business Practice Location Address
First Line	:	7447 W TALCOTT AVE STE 501
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-3716
Country	:	US
Telephone Number	:	773-631-7898
Fax Number	:	773-594-4113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	09/26/2018

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