Provider Demographics
NPI:1992903488
Name:ISAWI, HANNY (MD)
Entity type:Individual
Prefix:
First Name:HANNY
Middle Name:
Last Name:ISAWI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:IL
Mailing Address - Zip Code:61032-0268
Mailing Address - Country:US
Mailing Address - Phone:815-599-7924
Mailing Address - Fax:
Practice Address - Street 1:25 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:IL
Practice Address - Zip Code:61032-3801
Practice Address - Country:US
Practice Address - Phone:815-599-7785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT191692207W00000X
IL036-128638207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology