Provider Demographics
NPI:1598995680
Name:HOEFEN, HEATHER (DC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HOEFEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:258 HAYLER CT
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:WI
Mailing Address - Zip Code:53575-1108
Mailing Address - Country:US
Mailing Address - Phone:312-636-0011
Mailing Address - Fax:
Practice Address - Street 1:119 N HENRY ST
Practice Address - Street 2:
Practice Address - City:EDGERTON
Practice Address - State:WI
Practice Address - Zip Code:53534-1822
Practice Address - Country:US
Practice Address - Phone:312-636-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-22
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.010454111N00000X
WI4450-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor