Provider Demographics
NPI:1841449006
Name:SMITH, HANNAH (MSPT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:WOLFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSTP
Mailing Address - Street 1:24402 W LOCKPORT ST
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-4206
Mailing Address - Country:US
Mailing Address - Phone:815-609-7000
Mailing Address - Fax:815-609-7002
Practice Address - Street 1:24402 W LOCKPORT ST
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-4206
Practice Address - Country:US
Practice Address - Phone:815-609-7000
Practice Address - Fax:815-609-7002
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-016693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist