Provider Demographics
NPI:1821065673
Name:BOFF, MARC H (ATC, PT, DPT, CSCS)
Entity Type:Individual
Prefix:MR
First Name:MARC
Middle Name:H
Last Name:BOFF
Suffix:
Gender:M
Credentials:ATC, PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 LAKE COOK RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4921
Mailing Address - Country:US
Mailing Address - Phone:847-444-8732
Mailing Address - Fax:847-444-8998
Practice Address - Street 1:550 LAKE COOK RD
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4921
Practice Address - Country:US
Practice Address - Phone:847-444-8732
Practice Address - Fax:847-444-8998
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist