Doctor Name: | DAWN R HACKEL |
NPI Number: | 1124036546 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPM |
License Number: | 5047180002 |
Business Practice Address: | 153 N 19th Ave Melrose Park, IL - 601603702 |
Business Phone Number: | 7083444300 |
Business Fax Number: | 7083444358 |
Mailing Address: | 153 N 19th Ave, MELROSE PARK |
State: | IL |
Postal Code: | 601603702 |
Phone Number: | 7083444300 |
Fax Number: | 7083444358 |
NPI Enumeration Date: | 08/03/2006 |
NPI Last Update Date: | 01/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 5047180002 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |