Provider Demographics
NPI:1780604116
Name:CHEST & SLEEP MEDICINE ASSOCIATES S.C.
Entity type:Organization
Organization Name:CHEST & SLEEP MEDICINE ASSOCIATES S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-573-9031
Mailing Address - Street 1:755 S MILWAUKEE AVE STE 181
Mailing Address - Street 2:
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-3267
Mailing Address - Country:US
Mailing Address - Phone:847-855-2430
Mailing Address - Fax:847-855-2490
Practice Address - Street 1:755 S MILWAUKEE AVE STE 181
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-3267
Practice Address - Country:US
Practice Address - Phone:847-855-2430
Practice Address - Fax:847-855-2490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085568207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04927890OtherBLUE CROSS/SHIELD
IL04927890OtherBLUE CROSS/SHIELD
IL036085568Medicaid
IL04927890OtherBLUE CROSS/SHIELD