Provider Demographics
NPI:1548250780
Name:HOFFMAN, DENNIS SAUL (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:SAUL
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:847-855-2493
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:847-855-2493
Practice Address - Fax:847-855-2490
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-085568207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036085568Medicaid
IL04927890OtherBLUE CROSS/SHIELD
IL290014088OtherRAIL ROAD MEDICARE
IL04927890OtherBLUE CROSS/SHIELD
ILG45947Medicare UPIN