MEDICARE: DR. ROBIN HANNA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	36112298	IL
2	2085P0229X	Pediatric Radiology Physician	36112298	IL

General Provider Information

NPI Number	:	1235355876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN HANNA MD

Provider Business Mailing Address
First Line	:	737 W BELDEN AVE UNIT E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3331
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	737 W BELDEN AVE UNIT E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60614-3331
Country	:	US
Telephone Number	:	773-263-9270
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	12/31/2008

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