Provider Demographics
NPI:1134739931
Name:HOEKSTRA, JACEY GAIL (AUD)
Entity type:Individual
Prefix:DR
First Name:JACEY
Middle Name:GAIL
Last Name:HOEKSTRA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:JACEY
Other - Middle Name:GAIL
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7301 N KNOXVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-2017
Mailing Address - Country:US
Mailing Address - Phone:309-589-5900
Mailing Address - Fax:309-589-4631
Practice Address - Street 1:7301 N KNOXVILLE AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-2017
Practice Address - Country:US
Practice Address - Phone:309-589-5900
Practice Address - Fax:309-589-4631
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147001787231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist