Individual
HAN M HANAFY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MDSC
Contact information
Practice address
404 N COMMERCIAL ST, HARRISBURG, IL 62946-3307
(618) 252-7424
(618) 252-0737
Mailing address
PO BOX 783, HARRISBURG, IL 62946-0783
(618) 252-7424
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
01-042259
IN
208800000X
Urology Physician
Primary
36-45949
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08300064
BCBS IL. PROVIDER NUMBER
IL
Enumeration date
09/03/2006
Last updated
10/17/2010
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