Provider Demographics
NPI:1255653481
Name:HOSHAW, HILLARY D
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:D
Last Name:HOSHAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:954 W STATE ST
Mailing Address - Street 2:
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-1335
Mailing Address - Country:US
Mailing Address - Phone:815-895-9144
Mailing Address - Fax:815-895-5740
Practice Address - Street 1:954 W STATE ST
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-1335
Practice Address - Country:US
Practice Address - Phone:815-895-9144
Practice Address - Fax:815-895-5740
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085003665363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant