Provider Demographics
NPI:1689686529
Name:HANNA, WAFAA G (MD)
Entity Type:Individual
Prefix:DR
First Name:WAFAA
Middle Name:G
Last Name:HANNA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8650 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-5693
Mailing Address - Country:US
Mailing Address - Phone:630-230-0650
Mailing Address - Fax:630-230-0960
Practice Address - Street 1:18210 LA GRANGE RD STE 109
Practice Address - Street 2:
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-7723
Practice Address - Country:US
Practice Address - Phone:708-478-4666
Practice Address - Fax:708-478-8444
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics