Provider Demographics
NPI:1114342037
Name:HOFIUS, LAUREN KIMBERLY (CSA)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:KIMBERLY
Last Name:HOFIUS
Suffix:
Gender:F
Credentials:CSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 N CICERO AVE
Mailing Address - Street 2:#400
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-1651
Mailing Address - Country:US
Mailing Address - Phone:773-794-3100
Mailing Address - Fax:773-685-4520
Practice Address - Street 1:4211 N CICERO AVE
Practice Address - Street 2:#400
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-1651
Practice Address - Country:US
Practice Address - Phone:773-794-3100
Practice Address - Fax:773-685-4520
Is Sole Proprietor?:No
Enumeration Date:2014-02-28
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL238.000410246ZC0007X
WI4201246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant