Provider Demographics
NPI:1538119300
Name:HOFFMAN, MARCEL T (MD)
Entity Type:Individual
Prefix:DR
First Name:MARCEL
Middle Name:T
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 DOTY RD STE D
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:IL
Mailing Address - Zip Code:60098-7530
Mailing Address - Country:US
Mailing Address - Phone:815-338-6600
Mailing Address - Fax:815-206-1086
Practice Address - Street 1:3707 DOTY RD STE D
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:IL
Practice Address - Zip Code:60098
Practice Address - Country:US
Practice Address - Phone:815-338-6600
Practice Address - Fax:815-206-1086
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093917207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL110163798OtherMEDICARE RAILROAD
IL036093917OtherSTATE LICENSE