Provider Demographics
NPI:1477676617
Name:HAMEN, STEPHENIE D (MA)
Entity Type:Individual
Prefix:MRS
First Name:STEPHENIE
Middle Name:D
Last Name:HAMEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1691 QUEENSBURY CIR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-2835
Mailing Address - Country:US
Mailing Address - Phone:847-519-0828
Mailing Address - Fax:
Practice Address - Street 1:1855 S MOUNT PROSPECT RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60018-1885
Practice Address - Country:US
Practice Address - Phone:847-803-9444
Practice Address - Fax:847-803-9480
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILSH78400100P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist