Provider Demographics
NPI:1790106383
Name:HANSON, JOEL (DC)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:HANSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1131 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-1401
Mailing Address - Country:US
Mailing Address - Phone:630-250-9200
Mailing Address - Fax:
Practice Address - Street 1:24W500 MAPLE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6055
Practice Address - Country:US
Practice Address - Phone:630-428-4300
Practice Address - Fax:630-428-4305
Is Sole Proprietor?:No
Enumeration Date:2013-12-27
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor