Healthcare Provider Details

I. General information

NPI: 1225294911
Provider Name (Legal Business Name): HANNAH ALPHS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 E CHICAGO AVE TARRY 16-703
CHICAGO IL
60611-3008
US

IV. Provider business mailing address

510 W FULLERTON PKWY APT 312
CHICAGO IL
60614-6440
US

V. Phone/Fax

Practice location:
  • Phone: 312-908-8145
  • Fax: 312-908-7275
Mailing address:
  • Phone: 646-872-8609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number125054379
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2088P0231X
TaxonomyPediatric Urology Physician
License Number125054379
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: