Provider Demographics
NPI:1366948747
Name:HOFFMAN, MELISSA JO (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:JO
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 RODNEY ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:IL
Mailing Address - Zip Code:60441-3347
Mailing Address - Country:US
Mailing Address - Phone:815-342-8984
Mailing Address - Fax:
Practice Address - Street 1:1804 CENTRE POINT CIR STE 102
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4849
Practice Address - Country:US
Practice Address - Phone:630-995-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.012315225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist