MEDICARE: DR. JOHN PATRICK HANLON M.D.

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	207W00000X	Ophthalmology Physician		IL

General Provider Information

NPI Number	:	1871580175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN PATRICK HANLON M.D.

Provider Business Mailing Address
First Line	:	2850 W 95TH ST
Second Line	:	SUITE 401
City	:	EVERGREEN PARK
State	:	IL
Zip	:	60805-2735
Country	:	US
Telephone Number	:	708-499-5500
Fax Number	:	708-499-4200

Provider Business Practice Location Address
First Line	:	2850 W 95TH ST
Second Line	:	SUITE 401
City	:	EVERGREEN PARK
State	:	IL
Zip	:	60805-2735
Country	:	US
Telephone Number	:	708-499-5500
Fax Number	:	708-499-4200

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

Provider Enumeration Date	:	10/02/2005
Last Update Date	:	02/22/2008

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