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General NPI Number Information
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NPI Number | 1689244907
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Entity Type | Individual
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Provider Name | SCOTT HANSEN OD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2021
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 9501 171ST ST STE C
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City | TINLEY PARK
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State | IL
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Zip | 60487-6111
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Country | US
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Telephone | 708-403-8300
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Fax | 708-403-8333
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Provider Business Mailing Address
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Address Line | 9501 171ST ST STE C
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City | TINLEY PARK
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State | IL
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Zip | 60487-6111
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Country | US
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Telephone | 708-403-8300
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Fax | 708-403-8333
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046.011531
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License Number State | IL
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