Provider Demographics
NPI:1912930728
Name:HANN, SANG (MD)
Entity Type:Individual
Prefix:
First Name:SANG
Middle Name:
Last Name:HANN
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 1:9301 GOLF RD
Mailing Address - Street 2:SUITE206
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1667
Mailing Address - Country:US
Mailing Address - Phone:847-824-7740
Mailing Address - Fax:847-824-4618
Practice Address - Street 1:9301 GOLF RD
Practice Address - Street 2:SUITE206
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1667
Practice Address - Country:US
Practice Address - Phone:847-824-7740
Practice Address - Fax:847-824-4618
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD12246Medicare UPIN
ILL68966Medicare ID - Type Unspecified