Provider Demographics
NPI:1679740948
Name:HAN, JAE EUN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAE
Middle Name:EUN
Last Name:HAN
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 1:6 EAGLE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9393
Mailing Address - Country:US
Mailing Address - Phone:847-428-4929
Mailing Address - Fax:847-428-4929
Practice Address - Street 1:6 EAGLE POINTE DR
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9393
Practice Address - Country:US
Practice Address - Phone:847-428-4929
Practice Address - Fax:847-428-4929
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036046926207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology