Provider Demographics
NPI:1114005600
Name:HAN, SEHJIN (MD)
Entity Type:Individual
Prefix:
First Name:SEHJIN
Middle Name:
Last Name:HAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 N MICHIGAN AVE STE 1100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4529
Mailing Address - Country:US
Mailing Address - Phone:312-877-5522
Mailing Address - Fax:312-877-5521
Practice Address - Street 1:980 N MICHIGAN AVE STE 1100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4529
Practice Address - Country:US
Practice Address - Phone:312-877-5522
Practice Address - Fax:312-877-5521
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.124799207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC43191Medicare UPIN
IL478440Medicare PIN