Doctor Name: | CHRISTOPHER LEE HACK |
NPI Number: | 1811965361 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC |
License Number: | C2377 |
Business Practice Address: | 1801 E Lincoln Hwy New Lenox, IL - 604513801 |
Business Phone Number: | 8154622319 |
Business Fax Number: | |
Mailing Address: | 17530 Gilbert Dr, LOCKPORT |
State: | IL |
Postal Code: | 604411114 |
Phone Number: | 8155883515 |
Fax Number: | |
NPI Enumeration Date: | 03/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | C2377 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |