MEDICARE: TINA S HAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	336073885	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1616108	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1336141126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA S HAN MD

Provider Business Mailing Address
First Line	:	120 W 22ND ST STE 200
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1563
Country	:	US
Telephone Number	:	630-573-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 W GOLF RD
Second Line	:	SUITE 105
City	:	MT PROSPECT
State	:	IL
Zip	:	60056-4276
Country	:	US
Telephone Number	:	847-439-8780
Fax Number	:	847-298-6395

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	02/01/2023

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Directions to “ TINA S HAN MD” Practice Location

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