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General NPI Number Information
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NPI Number | 1992646228
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Entity Type | Individual
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Provider Name | LATRICE DIANE HATCH
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 211 DIXIE HWY STE 4
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City | CHICAGO HEIGHTS
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State | IL
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Zip | 60411-1696
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Country | US
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Telephone | 708-754-8880
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Fax | 312-569-6313
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Provider Business Mailing Address
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Address Line | 20827 SPARTA LN
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1944
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Country | US
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Telephone | 312-569-5609
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Fax | 312-569-6313
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041504489
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License Number State | IL
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