Dehaan, Michael R

Dehaan, Michael R is an individual health care provider with primary practice located at 675 W North Ave Suite 206, Melrose Park IL 60160-1634. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Dehaan, Michael R can be contacted via phone (708) 327-1540.

Contact Information

Primary practice address
675 W North Ave Suite 206 Melrose Park IL 60160-1634
Phone: (708) 327-1540
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 036073579 Illinois

Profile Details

NPI number 1770588287
LBN Legal business name Dehaan, Michael R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Feb 3rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770588287 NPPES
Illinois MEDICAID 0360735792
Illinois Other 0001635157
Illinois Other P00213432

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