Individual provider Active NPI

Kimberly S Hoffer, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Downers Grove, IL
National Provider Identifier
1053486258
Registry record updated Nov 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146-003150 Issued in IL
Practice address
3450 Lacey Rd
Alumni Hall 206
Downers Grove, IL 60515-5430
Phone
(630) 743-4500
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146-003150 IL Primary

Addresses

Primary practice location

3450 Lacey Rd
Alumni Hall 206
Downers Grove, IL 60515-5430

Mailing address

555 31St St
Alumni Hall 206
Downers Grove, IL 60515-1235
Phone (630) 515-6367

Other identifiers 1

IdentifierTypeStateIssuer
IL 1727004OtherILMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
146-003150ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwestern University Past Accepting new patients
Midwestern University Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480291200000",
    "number": "1053486258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 31ST ST",
            "address_2": "ALUMNI HALL 206",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151235",
            "telephone_number": "630-515-6367",
            "fax_number": "630-515-7665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "address_2": "ALUMNI HALL 206",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFER",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2016-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146-003150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "IL 1727004",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.