MEDICARE: INNA HOFFMAN APN

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	363LF0000X	Family Nurse Practitioner	209016212	IL
2	207Q00000X	Family Medicine Physician	277.000734	IL

General Provider Information

NPI Number	:	1568982742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	INNA HOFFMAN APN

Provider Business Mailing Address
First Line	:	PO BOX 6037
Second Line	:
City	:	WAUCONDA
State	:	IL
Zip	:	60084-6037
Country	:	US
Telephone Number	:	847-526-2151
Fax Number	:	847-526-2017

Provider Business Practice Location Address
First Line	:	1729 GREEN BAY RD
Second Line	:
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-3221
Country	:	US
Telephone Number	:	847-409-4516
Fax Number	:

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

Provider Enumeration Date	:	06/20/2017
Last Update Date	:	03/11/2026

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