Provider Demographics
NPI:1972779296
Name:HANUS, KURT MICHAEL (MA)
Entity Type:Individual
Prefix:MR
First Name:KURT
Middle Name:MICHAEL
Last Name:HANUS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9599 US HIGHWAY 12
Mailing Address - Street 2:
Mailing Address - City:NEW BUFFALO
Mailing Address - State:MI
Mailing Address - Zip Code:49117-9269
Mailing Address - Country:US
Mailing Address - Phone:312-409-4819
Mailing Address - Fax:
Practice Address - Street 1:115 E FIRST ST
Practice Address - Street 2:#1S
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-4254
Practice Address - Country:US
Practice Address - Phone:630-484-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180005412101YM0800X
MI6401009179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional