Individual
MICHAEL HANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
251 E HURON ST, CHICAGO, IL 60611-2908
(312) 926-7430
Mailing address
251 E HURON ST, CHICAGO, IL 60611-2908
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036173013
IL
2085R0202X
Diagnostic Radiology Physician
Primary
125077999
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/01/2020
Last updated
05/22/2025
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