Provider Demographics
NPI:1679128839
Name:HAHN, DANIELLE D
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:D
Last Name:HAHN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 FREEMONT ST
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-1256
Mailing Address - Country:US
Mailing Address - Phone:815-712-6158
Mailing Address - Fax:630-882-9419
Practice Address - Street 1:901 FREEMONT ST
Practice Address - Street 2:
Practice Address - City:YORKVILLE
Practice Address - State:IL
Practice Address - Zip Code:60560-1256
Practice Address - Country:US
Practice Address - Phone:815-712-6158
Practice Address - Fax:630-882-9419
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3747A0650XOtherTECHNICIAN-ATTENDANT CARE PROVIDE