Provider Demographics
NPI:1417597634
Name:ALBERT, HANNAH (PA-C)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:ALBERT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 N HERMITAGE AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-5078
Mailing Address - Country:US
Mailing Address - Phone:847-902-8075
Mailing Address - Fax:
Practice Address - Street 1:3800 HIGHLAND AVE STE 106
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1558
Practice Address - Country:US
Practice Address - Phone:630-960-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant