Individual
MELODY HOF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1325 CEDAR CT, CARBONDALE, IL 62901-5337
(618) 549-2911
(618) 549-2912
Mailing address
615 S SURREY LN, CARBONDALE, IL 62901-2110
(618) 534-2611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000897
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
371359450
FEDERAL EMPLOYER ID NUMBE
IL
01
—
970015211
RAILROAD PROVIDER NUMBER
IL
01
—
CB3700
RAILROAD MEDICARE GROUP #
IL
01
—
K16715
UMWA PROVIDER NUMBER
IL
01
—
L84851
UMWA PROVIDER NUMBER
IL
Enumeration date
06/30/2006
Last updated
12/11/2025
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