Healthcare Provider Details

I. General information

NPI: 1720070386
Provider Name (Legal Business Name): HANNA M SABA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 02/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 MEDICAL PARK DR
EFFINGHAM IL
62401
US

IV. Provider business mailing address

210 W. MCKINLEY AVE STE 1
DECATUR IL
62526
US

V. Phone/Fax

Practice location:
  • Phone: 217-342-2066
  • Fax: 217-342-2074
Mailing address:
  • Phone: 217-876-6600
  • Fax: 217-876-6606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberE3731
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036118085
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number036118085
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: