Provider Demographics
NPI:1265499271
Name:HATTEN, RISE CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:RISE
Middle Name:CAROL
Last Name:HATTEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RISE
Other - Middle Name:CAROL
Other - Last Name:CIEGLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1200 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:IL
Mailing Address - Zip Code:62450-2499
Mailing Address - Country:US
Mailing Address - Phone:618-395-5222
Mailing Address - Fax:618-395-8552
Practice Address - Street 1:1200 N EAST ST
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:IL
Practice Address - Zip Code:62450-2499
Practice Address - Country:US
Practice Address - Phone:618-395-5222
Practice Address - Fax:618-395-8552
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.119656207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
913732OtherHEALTHLINK
1223662OtherUNITED HEALTHCARE
146587OtherHEALTH ALLIANCE
146587OtherHEALTH ALLIANCE
IL$$$$$$$$$Medicaid
1223662OtherUNITED HEALTHCARE