MEDICARE: HANSERS ASSOCIATES

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	207Q00000X	Family Medicine Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1621962	OTHER	IL	BC/BS PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	2140333	OTHER	IL	AETNA LIFE
4	6147841	OTHER	IL	CIGNA
5	N278978	OTHER	IL	HARMONY HEALTH PLAN OF IL
6	541761812001	OTHER	IL	GREATER CHICAGO
7	05453	OTHER	IL	BLUE CHOICE PROVIDER NUM.
8	40433	OTHER	IL	ADVOCATE BETHANY PHO
9	800250040000	OTHER	IL	UNITED HEALTH CARE OF ILL
10	40527	OTHER	IL	ADVOCATE TRINITY PHO

General Provider Information

NPI Number	:	1356339790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANSERS ASSOCIATES

Provider Business Mailing Address
First Line	:	1473 RING RD
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-5459
Country	:	US
Telephone Number	:	708-862-8156
Fax Number	:	708-862-8159

Provider Business Practice Location Address
First Line	:	1473 RING RD
Second Line	:
City	:	CALUMET CITY
State	:	IL
Zip	:	60409-5459
Country	:	US
Telephone Number	:	708-862-8156
Fax Number	:	708-862-8159

Authorized Official
Title or Position	:	ATTENDING PHYSICIAN
Name	:	DR. ADEYEMI OLUDARE FATOKI
Credential	:	M.D
Telephone Number	:	708-862-8156

Provider Enumeration Date	:	10/10/2005
Last Update Date	:	08/22/2020

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Directions to “HANSERS ASSOCIATES ” Practice Location

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