Individual
MR. MICHAEL JOSEPH HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.ED, ATC
Contact information
Practice address
430 S MICHIGAN AVE, RM 362, CHICAGO, IL 60605-1315
(312) 341-4153
(312) 341-3522
Mailing address
4350 N BROADWAY ST APT 501, CHICAGO, IL 60613-4855
(515) 890-2995
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
100602039
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100602039
ATC
IL
Enumeration date
03/22/2007
Last updated
04/11/2013
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