MEDICARE: HOFFMAN OF BUCKTOWN PLLC

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	122300000X	Dentist

General Provider Information

NPI Number	:	1659223840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOFFMAN OF BUCKTOWN PLLC

Provider Business Mailing Address
First Line	:	443 W HURON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3412
Country	:	US
Telephone Number	:	312-267-1917
Fax Number	:

Provider Business Practice Location Address
First Line	:	1934 W NORTH AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-1318
Country	:	US
Telephone Number	:	312-219-5448
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NATHAN HOFFMAN
Credential	:	DDS
Telephone Number	:	312-505-0168

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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