Provider Demographics
NPI:1093572794
Name:ECHEVARRIA, HANA S (LMT, OMT, MLDT)
Entity Type:Individual
Prefix:
First Name:HANA
Middle Name:S
Last Name:ECHEVARRIA
Suffix:
Gender:F
Credentials:LMT, OMT, MLDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 ORIOLE LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-1859
Mailing Address - Country:US
Mailing Address - Phone:773-317-7537
Mailing Address - Fax:
Practice Address - Street 1:1910 S HIGHLAND AVE STE 260
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6129
Practice Address - Country:US
Practice Address - Phone:630-776-3043
Practice Address - Fax:630-929-1390
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227022644225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist