Provider Demographics
NPI:1649225962
Name:HANN, PATRICK C (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:C
Last Name:HANN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5550 TOUHY AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-3227
Mailing Address - Country:US
Mailing Address - Phone:773-631-5788
Mailing Address - Fax:847-423-2939
Practice Address - Street 1:5550 TOUHY AVE STE 402
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-3227
Practice Address - Country:US
Practice Address - Phone:773-631-5788
Practice Address - Fax:847-423-2939
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL190159941223G0001X, 122300000X
332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral Practice
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment