Provider Demographics
NPI:1780846147
Name:HAN, ANITA MI-YOUNG (OD)
Entity Type:Individual
Prefix:DR
First Name:ANITA
Middle Name:MI-YOUNG
Last Name:HAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3581
Mailing Address - Country:US
Mailing Address - Phone:224-676-1022
Mailing Address - Fax:
Practice Address - Street 1:2013 MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:RIVERWOODS
Practice Address - State:IL
Practice Address - Zip Code:60015-3581
Practice Address - Country:US
Practice Address - Phone:224-676-1022
Practice Address - Fax:224-676-2050
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010088152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist