Healthcare Provider Details

I. General information

NPI: 1508780271
Provider Name (Legal Business Name): ROBERT M HANSON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 KENNETH AVE
SKOKIE IL
60076-3820
US

IV. Provider business mailing address

7500 KENNETH AVE # 507
SKOKIE IL
60076-3820
US

V. Phone/Fax

Practice location:
  • Phone: 347-204-0153
  • Fax:
Mailing address:
  • Phone: 347-204-0153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.031997
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: