Active NPI
Ian E Hoffman, PSYD
- Clinical Psychologist
- Palos Heights, IL
National Provider Identifier
1750654596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 071.010364
- Practice address
- 11800 S 75TH Ave FL 3
Palos Heights, IL 60463-1033 - Phone
- (708) 671-8440
- Fax
- (630) 859-2994
- NPI assigned
- Feb 9, 2012
- Last updated
- Oct 5, 2020
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 071.010364 | IL | Primary |
Addresses
Primary practice location
11800 S 75TH Ave FL 3
Palos Heights, IL 60463-1033
Mailing address
281 W Washington St
Oswego, IL 60543-9817
Phone (320) 260-5915
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071.010364 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miracare Neuro Behavioral Health, PC | Counselor | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Oswego, IL
- NPI 1053232231
-
dba Palos Behavioral Health Professionals
- Psychologist
- Palos Heights, IL
- NPI 1649329251
Counselor
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601856000000",
"number": "1750654596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "281 W WASHINGTON ST",
"city": "OSWEGO",
"state": "IL",
"postal_code": "605439817",
"telephone_number": "320-260-5915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11800 S 75TH AVE FL 3",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631033",
"telephone_number": "708-671-8440",
"fax_number": "630-859-2994"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOFFMAN",
"first_name": "IAN",
"middle_name": "E",
"name_prefix": "Mr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-02-09",
"last_updated": "2020-10-05",
"certification_date": "2020-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": "071.010364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palos Heights, IL
- Hunter James Hicks, MD
- High Technology Inc (High Tech Medical Park)
- High Technology, Inc. (High Tech Medical Park)
- Highland Park CVS LLC (CVS Pharmacy #05819)
- Mary Ann L Hodorowicz, RD, LDN, MBA, CDE
- Vickie Lyn Hoffman, OTR
- Hofstra Family Hearing Center Inc
- Lyndi Sue Hofstra, BS HIS
- Tina M Holba, ATC
- Rachel Holcomb, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.