Provider Demographics
NPI:1932744018
Name:TOWNSEND, HANNAH (PTA)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 LAYNE CT
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-0652
Mailing Address - Country:US
Mailing Address - Phone:815-409-8684
Mailing Address - Fax:
Practice Address - Street 1:1816 170TH ST
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-1451
Practice Address - Country:US
Practice Address - Phone:708-335-1415
Practice Address - Fax:708-335-0728
Is Sole Proprietor?:No
Enumeration Date:2019-11-12
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160008843225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL362986646OtherTIN