Provider Demographics
NPI:1467442251
Name:HANZEL, DUANE ANTHONY (DPM)
Entity type:Individual
Prefix:DR
First Name:DUANE
Middle Name:ANTHONY
Last Name:HANZEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2834
Mailing Address - Country:US
Mailing Address - Phone:217-223-8400
Mailing Address - Fax:
Practice Address - Street 1:4800 MAINE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62305-5875
Practice Address - Country:US
Practice Address - Phone:217-214-3823
Practice Address - Fax:217-277-5596
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002006340213ES0131X
IL016-005009213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6450976001OtherCIGNA
IL475640OtherHEALTHLINK
IL068824OtherHEALTH ALLIANCE
IL016005009Medicaid
IL132005OtherBC/BS
MO307352609Medicaid
IL4544460001Medicare NSC
IL480034047Medicare ID - Type UnspecifiedRAILROAD
MO000021535Medicare PIN
IL132005OtherBC/BS
MO307352609Medicaid
ILL92215Medicare PIN