| Doctor Name: | CORINNE HANSEN |
| NPI Number: | 1033518667 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 085005151 |
| Business Practice Address: | 4119 W Shamrock Ln Suite 201 Mchenry, IL - 600508268 |
| Business Phone Number: | 8157599407 |
| Business Fax Number: | 8157599475 |
| Mailing Address: | 4119 W Shamrock Ln, Suite 201 MCHENRY |
| State: | IL |
| Postal Code: | 600508268 |
| Phone Number: | 8157599407 |
| Fax Number: | 8157599475 |
| NPI Enumeration Date: | 08/20/2014 |
| NPI Last Update Date: | 08/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 085005151 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |