Provider Demographics
NPI:1831482769
Name:HANA, MICHAEL SHEHATA
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SHEHATA
Last Name:HANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:SHEHATA
Other - Last Name:SHEHATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7 HEGEMAN AVE
Mailing Address - Street 2:18 E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-4756
Mailing Address - Country:US
Mailing Address - Phone:347-281-2127
Mailing Address - Fax:
Practice Address - Street 1:60 ORLAND SQUARE DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6548
Practice Address - Country:US
Practice Address - Phone:708-914-5145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8300207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400182883Medicare PIN