Provider Demographics
NPI:1730216458
Name:VILLAGE OF HOFFMAN ESTATES
Entity type:Organization
Organization Name:VILLAGE OF HOFFMAN ESTATES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAVEDRA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:847-781-4850
Mailing Address - Street 1:1900 HASSELL RD
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-6308
Mailing Address - Country:US
Mailing Address - Phone:847-781-4850
Mailing Address - Fax:847-781-4869
Practice Address - Street 1:1900 HASSELL RD
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-6308
Practice Address - Country:US
Practice Address - Phone:847-781-4850
Practice Address - Fax:847-781-4869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041220171251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL333730Medicare ID - Type UnspecifiedPROVIDER NUMBER