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Individual

MR. THOMAS HAROLD HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(224) 610-3874
Mailing address
1030 WAUKEGAN RD, DEERFIELD, IL 60015-3035
(224) 610-3874

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1506
FL

Other

Enumeration date
01/30/2006
Last updated
08/13/2009
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