Healthcare Provider Details

I. General information

NPI: 1427806140
Provider Name (Legal Business Name): HANNA WEBER APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 08/14/2024
Certification Date: 08/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 MIDLANDS CT
SYCAMORE IL
60178-3125
US

IV. Provider business mailing address

2111 MIDLANDS CT
SYCAMORE IL
60178-3125
US

V. Phone/Fax

Practice location:
  • Phone: 815-787-7412
  • Fax:
Mailing address:
  • Phone: 815-758-0000
  • Fax: 815-756-7130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209030204
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSTUDENT
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: