Organization
REID HANSEN, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REID HERMAN HANSEN M.D. (OWNER)
(309) 637-3500
Entity
Organization
Contact information
Practice address
900 MAIN ST, SUITE 500, PEORIA, IL 61602-1005
(309) 637-3500
Mailing address
900 MAIN ST, SUITE 500, PEORIA, IL 61602-1005
(309) 637-3500
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
IL
Other
Enumeration date
03/21/2008
Last updated
03/21/2008
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