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Individual

DAWN R HACKEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
153 N 19TH AVE, MELROSE PARK, IL 60160-3702
(708) 344-4300
(708) 344-4358
Mailing address
153 N 19TH AVE, MELROSE PARK, IL 60160-3702
(708) 344-4300
(708) 344-4358

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004903
IL
332B00000X
Durable Medical Equipment & Medical Supplies
5047180002
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DA6978
MEDICARE RAILROAD
IL
Enumeration date
08/03/2006
Last updated
09/14/2020
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