Hansen, Kathleen Marie
Hansen, Kathleen Marie is an individual health care provider with primary practice located at 7212 Edgebrook Ln , Hanover Park IL 60133. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Hansen, Kathleen Marie can be contacted via phone (630) 837-3700.Contact Information
Primary practice address
7212 Edgebrook Ln
Hanover Park IL 60133
Phone: (630) 837-3700
Fax: (630) 837-3849
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | Illinois |
Profile Details
| NPI number | 1609867092 |
|---|---|
| LBN Legal business name | Hansen, Kathleen Marie |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 3rd, 2005 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609867092 | NPPES |
| Illinois | MEDICAID | 102598 |
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