MEDICARE: JEAN HOFFMAN

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	225200000X	Physical Therapy Assistant	160.004853	IL

General Provider Information

NPI Number	:	1871942631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEAN HOFFMAN

Provider Business Mailing Address
First Line	:	5223 W NEWPORT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-3331
Country	:	US
Telephone Number	:	708-646-8815
Fax Number	:

Provider Business Practice Location Address
First Line	:	5223 W NEWPORT AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-3331
Country	:	US
Telephone Number	:	708-646-8815
Fax Number	:

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

Provider Enumeration Date	:	06/12/2016
Last Update Date	:	06/12/2016

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Directions to “ JEAN HOFFMAN ” Practice Location

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