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General NPI Number Information
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NPI Number | 1376334870
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Entity Type | Organization
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Legal Business Name | HANSAMSSP LLC
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/14/2025
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Provider Practice Location Address
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Address Line | 521 E 86TH AVE STE Z
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6236
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Country | US
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Telephone | 312-933-5719
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Fax |
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Provider Business Mailing Address
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Address Line | 746 LOCUST RD
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City | WILMETTE
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State | IL
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Zip | 60091-2240
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Country | US
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Telephone | 312-933-5719
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Fax | 888-664-1191
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHIRAG PATEL
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Credential |
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Telephone | 312-933-5719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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