Provider Demographics
NPI:1164514030
Name:HOFFMAN, ALEXANDER R (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:R
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6157 N KILPATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5042
Mailing Address - Country:US
Mailing Address - Phone:773-841-2144
Mailing Address - Fax:
Practice Address - Street 1:6157 N KILPATRICK AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5042
Practice Address - Country:US
Practice Address - Phone:773-841-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051040456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist