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NPI Code Detail

MEDICARE: STEPHEN B HANAUER MD

MEDICARE: STEPHEN B HANAUER 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
1207RG0100XGastroenterology Physician036057399IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992868418
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN B HANAUER MD
Provider Business Mailing Address
First Line : 680 N LAKE SHORE DR
Second Line : SUITE 1000
City : CHICAGO
State : IL
Zip : 60611-4546
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST STE 650
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2929
Country : US
Telephone Number : 312-695-5620
Fax Number : 312-695-2310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2006
Last Update Date : 05/23/2017

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Directions to “ STEPHEN B HANAUER MD” Practice Location

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