Provider Demographics
NPI:1386804615
Name:HANSA MEDICAL GROUPE, LLC
Entity type:Organization
Organization Name:HANSA MEDICAL GROUPE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHIRAG
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-920-0902
Mailing Address - Street 1:5250 OLD ORCHARD RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-4462
Mailing Address - Country:US
Mailing Address - Phone:847-920-0902
Mailing Address - Fax:847-920-0901
Practice Address - Street 1:5250 OLD ORCHARD RD STE 300
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-4462
Practice Address - Country:US
Practice Address - Phone:847-920-0902
Practice Address - Fax:847-920-0901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-10
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100595207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty