Organization
HAN M HANAFY MDSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAN M HANAFY MDSC (OWNER)
61825274724
Entity
Organization
Contact information
Practice address
404 N COMMERCIAL ST, HARRISBURG, IL 62946-3307
(618) 252-7424
(618) 252-0737
Mailing address
PO BOX 783, HARRISBURG, IL 62946-0783
(618) 252-7424
(618) 252-0737
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
36-45949
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0065501
UMWA THE FUNDS
IL
05
—
036045949
—
IL
01
—
08300064
BLUE CROSS BLUE SHIELD
IL
01
—
101929
BLACK LUNG
IL
01
—
108688
HEALTHLINK
IL
01
—
L002199
CHAMPUS
IL
Enumeration date
08/31/2006
Last updated
10/15/2010
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