Individual
DAVID L. HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5000 PRAIRIE ROSE DR, ROSCOE, IL 61073-7792
(815) 971-2000
(815) 971-9417
Mailing address
5000 PRAIRIE ROSE DR, ROSCOE, IL 61073-7792
(815) 971-2000
(815) 971-9417
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-062691
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062691
—
IL
Enumeration date
08/30/2006
Last updated
02/24/2010
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