Individual
THOMAS S HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6755
(618) 463-7311
Mailing address
938 MCPHERSON AVE, ALTON, IL 62002-2256
(618) 462-4281
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036-090592
IL
207R00000X
Internal Medicine Physician
036-090592
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0008232117
BLUE CROSS BLUE SHIELD
IL
05
—
036090592
—
IL
01
—
06032182
BLUE CROSS BLUE SHIELD
IL
01
—
08232204
BLUE CROSS BLUE SHIELD
IL
01
—
08232205
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/22/2006
Last updated
03/10/2021
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