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General NPI Number Information
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NPI Number | 1396393880
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Entity Type | Individual
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Provider Name | ELIZABETH STEWART HANNA
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Gender | Female
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 1N141 COUNTY FARM RD STE 130
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City | WINFIELD
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State | IL
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Zip | 60190-2086
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Country | US
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Telephone | 630-752-9725
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Fax |
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Provider Business Mailing Address
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Address Line | 711 PARKWAY DR
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City | WHEATON
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State | IL
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Zip | 60187-3646
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Country | US
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Telephone | 630-877-3840
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149013275
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License Number State | IL
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