Individual
DONALD HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OWNER
Contact information
Practice address
541 SPRUCE RD, BOLINGBROOK, IL 60440-2504
(630) 750-7378
(630) 929-8057
Mailing address
541 SPRUCE RD, BOLINGBROOK, IL 60440-2504
(630) 750-7378
(630) 929-8057
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D2099042
IL
Other
Enumeration date
11/13/2015
Last updated
11/13/2015
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