Active NPI
Michael Darryl Hoffman, C.O.F.
- Orthotic Fitter
- Willowbrook, IL
National Provider Identifier
1093840613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- Practice address
- 7640 Plaza CT
Willowbrook, IL 60527-5607 - Phone
- (630) 686-3922
- Fax
- (630) 566-5939
- NPI assigned
- Feb 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | Primary |
Addresses
Primary practice location
7640 Plaza CT
Willowbrook, IL 60527-5607
Mailing address
7640 Plaza CT
Willowbrook, IL 60527-5607
Phone (630) 686-3922
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01623063 | Other | IL | BLUE CROSS PROVIDER NUMBE |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543968000000",
"number": "1093840613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7640 PLAZA CT",
"city": "WILLOWBROOK",
"state": "IL",
"postal_code": "605275607",
"telephone_number": "630-686-3922",
"fax_number": "630-566-5939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7640 PLAZA CT",
"city": "WILLOWBROOK",
"state": "IL",
"postal_code": "605275607",
"telephone_number": "630-686-3922",
"fax_number": "630-566-5939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOFFMAN",
"first_name": "MICHAEL",
"middle_name": "DARRYL",
"credential": "C.O.F.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2018-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER NUMBE",
"identifier": "01623063",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Willowbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.