Individual
ANNE HASEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
95 S MCHENRY AVE, CRYSTAL LAKE, IL 60014-6043
(815) 353-2411
(224) 333-6710
Mailing address
PO BOX 1723, CRYSTAL LAKE, IL 60039-1723
(815) 356-7680
(815) 356-7864
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-004170
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005683004
BLUE CROSS/BLUE SHIELD
IL
Enumeration date
09/04/2006
Last updated
11/08/2017
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