Provider Demographics
NPI:1225462120
Name:HASE ZAHN IN
Entity Type:Organization
Organization Name:HASE ZAHN IN
Other - Org Name:HASE ZAHN INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMONA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAREKET
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-571-0167
Mailing Address - Street 1:904 DORSET DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-3002
Mailing Address - Country:US
Mailing Address - Phone:847-571-0167
Mailing Address - Fax:
Practice Address - Street 1:1464 TOWNLINE RD
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-4433
Practice Address - Country:US
Practice Address - Phone:847-566-7850
Practice Address - Fax:847-566-7851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0273161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty