Healthcare Provider Details

I. General information

NPI: 1548706856
Provider Name (Legal Business Name): MONICA HAMMAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MONICA LAMBERT

II. Dates (important events)

Enumeration Date: 01/10/2017
Last Update Date: 01/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 N TELEGRAPH RD
MONROE MI
48162-5139
US

IV. Provider business mailing address

790 REMINGTON BLVD
BOLINGBROOK IL
60440-4909
US

V. Phone/Fax

Practice location:
  • Phone: 734-242-4866
  • Fax: 734-242-3559
Mailing address:
  • Phone: 630-296-2222
  • Fax: 630-759-9510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501017979
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: