Provider Demographics
NPI:1770559031
Name:HANIF, SOHAIL (MD)
Entity type:Individual
Prefix:DR
First Name:SOHAIL
Middle Name:
Last Name:HANIF
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 1:215 E 1ST ST,
Mailing Address - Street 2:STE 212A
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021
Mailing Address - Country:US
Mailing Address - Phone:815-285-5572
Mailing Address - Fax:815-285-5573
Practice Address - Street 1:215 E 1ST ST,
Practice Address - Street 2:STE 212A
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021
Practice Address - Country:US
Practice Address - Phone:815-285-5572
Practice Address - Fax:815-285-5573
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-87629207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK02528Medicare PIN
G51081Medicare UPIN