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Individual

MS. IRENE HAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
810 W ANTHONY DR, URBANA, IL 61802-7431
(217) 326-2911
(217) 344-8047
Mailing address
611 W PARK ST, URBANA, IL 61801-2500
(217) 326-2911
(217) 344-8047

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
113326
HEALTHLINK PROV ID
01
203
BLUE CROSS PROV ID
IL
01
4117
HAMP PROVIDER ID
IL
01
7216
PERSONALCARE PROV ID
Enumeration date
04/19/2007
Last updated
07/08/2007
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