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General NPI Number Information
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NPI Number | 1578477113
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY HAHNDORF DPT
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Gender | Male
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 1916 GATEWAY CENTER DR
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City | BELVIDERE
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State | IL
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Zip | 61008-9303
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Country | US
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Telephone | 815-547-9580
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Fax | 815-547-9930
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Provider Business Mailing Address
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Address Line | 650 CASSIA CT
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City | CRYSTAL LAKE
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State | IL
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Zip | 60012-2313
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Country | US
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Telephone | 815-321-3147
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.027938
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License Number State | IL
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