Provider Demographics
NPI:1104990993
Name:HANOVER TOWNSHIP
Entity type:Organization
Organization Name:HANOVER TOWNSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAIN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:CLERK
Authorized Official - Phone:630-837-0301
Mailing Address - Street 1:250 S ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-1648
Mailing Address - Country:US
Mailing Address - Phone:630-837-0301
Mailing Address - Fax:630-837-9064
Practice Address - Street 1:240 S ROUTE 59
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-1648
Practice Address - Country:US
Practice Address - Phone:630-483-5665
Practice Address - Fax:630-483-5662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health