Provider Demographics
NPI:1346658937
Name:HOVI, MICHAEL A (LMT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:HOVI
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 N SEMINARY AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-2980
Mailing Address - Country:US
Mailing Address - Phone:815-338-9150
Mailing Address - Fax:
Practice Address - Street 1:1400 N SEMINARY AVE
Practice Address - Street 2:SUITE K
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098-2980
Practice Address - Country:US
Practice Address - Phone:815-338-9150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-27
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227000224225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist