Individual
DR. AMI TALATI HANNAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
10733 165TH ST, ORLAND PARK, IL 60467-8713
(708) 957-7468
(708) 957-7471
Mailing address
PO BOX 603725, CHARLOTTE, NC 28260-3725
(828) 575-2625
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
036-117880
IL
207R00000X
Internal Medicine Physician
036-117880
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114880
—
NC
01
—
F401092725
MEDICARE PTAN
IL
Enumeration date
06/27/2007
Last updated
07/29/2024
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