Provider Demographics
NPI:1619551819
Name:HOVING, CHRISTINE CAROL
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CAROL
Last Name:HOVING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1049 E WILSON ST STE 120
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-3160
Mailing Address - Country:US
Mailing Address - Phone:630-938-8636
Mailing Address - Fax:
Practice Address - Street 1:1049 E WILSON ST STE 120
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-3160
Practice Address - Country:US
Practice Address - Phone:630-938-8636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160005146225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty