Provider Demographics
NPI:1750845806
Name:HOHL, ELISE RENEE (MS, OTR/L, ATC)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:RENEE
Last Name:HOHL
Suffix:
Gender:F
Credentials:MS, OTR/L, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11026 S HOYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-3318
Mailing Address - Country:US
Mailing Address - Phone:773-510-5904
Mailing Address - Fax:
Practice Address - Street 1:11053 S MILLARD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655-3327
Practice Address - Country:US
Practice Address - Phone:773-253-9856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
IL056.015665225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer