Provider Demographics
NPI:1154540649
Name:HAHN, KATE (RPH)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:HAHN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 BROOKHAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60554-9411
Mailing Address - Country:US
Mailing Address - Phone:630-466-0266
Mailing Address - Fax:
Practice Address - Street 1:426 BROOKHAVEN CIR
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:IL
Practice Address - Zip Code:60554-9411
Practice Address - Country:US
Practice Address - Phone:630-466-0266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051038832183500000X
AZS09871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist