Healthcare Provider Details

I. General information

NPI: 1881430692
Provider Name (Legal Business Name): HANNAH KRISTINE ROVANG PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 COMMERCE DR STE 600
OAK BROOK IL
60523-8865
US

IV. Provider business mailing address

1001 COMMERCE DR STE 600
OAK BROOK IL
60523-8865
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-1500
  • Fax: 331-732-4581
Mailing address:
  • Phone: 630-933-1500
  • Fax: 331-732-4581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2022025193
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070028644
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: