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General NPI Number Information
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NPI Number | 1265499271
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Entity Type | Individual
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Provider Name | RISE CAROL HATTEN MD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 1120 N EAST ST
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City | OLNEY
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State | IL
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Zip | 62450-6927
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Country | US
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Telephone | 618-395-5222
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Fax | 618-395-8552
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Provider Business Mailing Address
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Address Line | 1120 N EAST ST
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City | OLNEY
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State | IL
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Zip | 62450-6927
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Country | US
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Telephone | 618-395-5222
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Fax | 618-395-8552
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036.119656
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License Number State | IL
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