Provider Demographics
NPI:1528196961
Name:HOEPER, DAVID ANDRE (MA, LPT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANDRE
Last Name:HOEPER
Suffix:
Gender:M
Credentials:MA, LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 WHITETAIL LN.
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:IL
Mailing Address - Zip Code:61748
Mailing Address - Country:US
Mailing Address - Phone:309-485-0199
Mailing Address - Fax:
Practice Address - Street 1:201 WHITETAIL LN.
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:IL
Practice Address - Zip Code:61748
Practice Address - Country:US
Practice Address - Phone:309-485-0199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL12732485225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL12732485OtherLICENSED PHYSICAL THERAPI