Provider Demographics
NPI:1063704625
Name:HAMMEL, MARYANNE S (PT)
Entity type:Individual
Prefix:MRS
First Name:MARYANNE
Middle Name:S
Last Name:HAMMEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-1524
Mailing Address - Country:US
Mailing Address - Phone:847-776-5944
Mailing Address - Fax:
Practice Address - Street 1:55 S GREELEY ST
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-6174
Practice Address - Country:US
Practice Address - Phone:847-963-1483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070006559225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist