Provider Demographics
NPI:1558798561
Name:HAAN, ALAN MARSHAL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MARSHAL
Last Name:HAAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N MADISON ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-9470
Mailing Address - Country:US
Mailing Address - Phone:630-554-8431
Mailing Address - Fax:
Practice Address - Street 1:150 N MADISON ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-9470
Practice Address - Country:US
Practice Address - Phone:630-554-8431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3648959207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty