NPIMap

Individual provider Active NPI

Catherine Lerose Hoffner, D.M.D.

  • Dentist
  • Libertyville, IL
National Provider Identifier
1144629338
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030020 Issued in IL
Practice address
1900 Hollister Dr
#190
Libertyville, IL 60048-5227
Phone
(847) 680-0975
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019030020 IL Primary

Addresses

Primary practice location

1900 Hollister Dr
#190
Libertyville, IL 60048-5227

Mailing address

1900 Hollister Dr
#190
Libertyville, IL 60048-5227
Phone (847) 680-0975

Other names 1

  • Dr. Catherine Ann Lerose Former name

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

State licenses

LicenseStateTypeSpecialty
019030020ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
NSP Dental LLC PastSince Oct 25, 2020 Accepting new patients

Organizations & group practices 1

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513123200000",
    "number": "1144629338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 HOLLISTER DR",
            "address_2": "#190",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485227",
            "telephone_number": "847-680-0975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 HOLLISTER DR",
            "address_2": "#190",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600485227",
            "telephone_number": "847-680-0975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOFFNER",
        "first_name": "CATHERINE",
        "middle_name": "LEROSE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2017-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "LEROSE",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "D.M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.