Provider Demographics
NPI:1356339790
Name:HANSERS ASSOCIATES
Entity type:Organization
Organization Name:HANSERS ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEYEMI
Authorized Official - Middle Name:OLUDARE
Authorized Official - Last Name:FATOKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-862-8156
Mailing Address - Street 1:1473 RING RD
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-5459
Mailing Address - Country:US
Mailing Address - Phone:708-862-8156
Mailing Address - Fax:708-862-8159
Practice Address - Street 1:1473 RING RD
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-5459
Practice Address - Country:US
Practice Address - Phone:708-862-8156
Practice Address - Fax:708-862-8159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1621962OtherBC/BS PROVIDER NUMBER
IL0360847295Medicaid
IL2140333OtherAETNA LIFE
IL6147841OtherCIGNA
ILN278978OtherHARMONY HEALTH PLAN OF IL
IL541761812001OtherGREATER CHICAGO
IL05453OtherBLUE CHOICE PROVIDER NUM.
IL40433OtherADVOCATE BETHANY PHO
IL800250040000OtherUNITED HEALTH CARE OF ILL
IL40527OtherADVOCATE TRINITY PHO
IL6147841OtherCIGNA
ILN278978OtherHARMONY HEALTH PLAN OF IL