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General NPI Number Information
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NPI Number | 1356339790
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Entity Type | Organization
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Legal Business Name | HANSERS ASSOCIATES
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1473 RING RD
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City | CALUMET CITY
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State | IL
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Zip | 60409-5459
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Country | US
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Telephone | 708-862-8156
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Fax | 708-862-8159
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Provider Business Mailing Address
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Address Line | 1473 RING RD
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City | CALUMET CITY
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State | IL
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Zip | 60409-5459
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Country | US
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Telephone | 708-862-8156
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Fax | 708-862-8159
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Authorized Official
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Title or Position | ATTENDING PHYSICIAN
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Name | DR. ADEYEMI OLUDARE FATOKI
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Credential | M.D
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Telephone | 708-862-8156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | IL
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