Healthcare Provider Details

I. General information

NPI: 1417597634
Provider Name (Legal Business Name): HANNAH DUCKWORTH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 S MICHIGAN AVE FL 1
CHICAGO IL
60616-2104
US

IV. Provider business mailing address

950 W HURON ST UNIT 208
CHICAGO IL
60642-6678
US

V. Phone/Fax

Practice location:
  • Phone: 312-820-9688
  • Fax:
Mailing address:
  • Phone: 847-902-8075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: