Provider Demographics
NPI:1114155728
Name:DR. GREGORY S. HOFFMAN
Entity Type:Organization
Organization Name:DR. GREGORY S. HOFFMAN
Other - Org Name:RIVER NORTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:224-944-6112
Mailing Address - Street 1:PO BOX 1307
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60011-1307
Mailing Address - Country:US
Mailing Address - Phone:224-944-6112
Mailing Address - Fax:847-515-4747
Practice Address - Street 1:401 W ONTARIO ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-6957
Practice Address - Country:US
Practice Address - Phone:224-944-6112
Practice Address - Fax:847-515-4747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038008853111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty