| Organization Name: | HANSEL M DEBARTOLO JR MD SC |
| NPI Number: | 1518223791 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HANSEL M DEBARTOLO (PRESIDENT) |
| Mailing Address: | 11 Debartolo Dr. Sugar Grove |
| State: | IL US |
| Postal Code: | 60554 |
| Phone Number: | 6308591818 |
| Fax Number: | 6308591830 |
| NPI Enumeration Date: | 04/02/2012 |
| NPI Last Update Date: | 05/08/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | 036-054436 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |