Healthcare Provider Details

I. General information

NPI: 1679524987
Provider Name (Legal Business Name): HANNAH B. MICH CPT, MED, PES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 DEERFIELD PKWY
BUFFALO GROVE IL
60089-7500
US

IV. Provider business mailing address

301 E CONGRESS PKWY UNIT 932
CRYSTAL LAKE IL
60039-3440
US

V. Phone/Fax

Practice location:
  • Phone: 815-201-5836
  • Fax: 866-508-7769
Mailing address:
  • Phone: 815-201-5836
  • Fax: 866-508-7769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: