Provider Demographics
NPI:1720070386
Name:SABA, HANNA M (MD)
Entity Type:Individual
Prefix:MR
First Name:HANNA
Middle Name:M
Last Name:SABA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W. MCKINLEY AVE
Mailing Address - Street 2:STE 1
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526
Mailing Address - Country:US
Mailing Address - Phone:217-876-6600
Mailing Address - Fax:217-876-6606
Practice Address - Street 1:905 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401
Practice Address - Country:US
Practice Address - Phone:217-342-2066
Practice Address - Fax:217-342-2074
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE3731207RH0003X
IL036118085207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036118085Medicaid
IL036118085OtherSTATE LICENSE NUMBER
IL036118085OtherSTATE LICENSE NUMBER
IL036118085Medicaid
0970490001Medicare NSC
K37573Medicare PIN