Provider Demographics
NPI:1417019878
Name:HOFMAN, CRISTINA (PT)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:HOFMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 W TALCOTT AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3716
Mailing Address - Country:US
Mailing Address - Phone:773-631-7898
Mailing Address - Fax:773-594-4113
Practice Address - Street 1:7447 W TALCOTT AVE STE 501
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3716
Practice Address - Country:US
Practice Address - Phone:773-631-7898
Practice Address - Fax:773-594-4113
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700154522251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1623066OtherBCBS GROUP #
ILCJ4383OtherR.R. MEDICARE GROUP #
IL200852Medicare ID - Type UnspecifiedMEDICARE GROUP #
IL567770Medicare ID - Type UnspecifiedMEDICARE GROUP #
IL1623066OtherBCBS GROUP #
ILK34796Medicare PIN
ILK34794Medicare PIN
ILK34795Medicare PIN