Hannah Grace Henrichsen, PA-C
Individual provider Active NPI Physician Assistant · Tinley Park, IL
NPI 1104544022 · NPPES record last updated Aug 16, 2022
Key facts
- NPI
- 1104544022
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 085.009007 (IL)
- Practice address
- 16255 Harlem Ave
Tinley Park, IL 60477-1615 - Phone
- (708) 599-5000
- NPI assigned
- Aug 16, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Orthopedic and Spine Care SC
Practice addresses (Care Compare)
12251 S 80TH Ave
Palos Heights, IL 60463-1290
Phone (708) 923-4000
16255 Harlem Ave
Tinley Park, IL 60477-1615
Phone (708) 599-5000
4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000
6701 W 95TH St
Oak Lawn, IL 60453-2105
Phone (708) 599-5000
Hospital & facility affiliations
- Advocate Christ Hospital & Medical Center
- Palos Community Hospital
- Osf Little Company of Mary Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230301000764 | IL | Practitioner - Physician Assistant | 0547633109 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085.009007 | IL | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.009007 | IL | Yes |
Addresses
Primary practice location
16255 Harlem Ave
Tinley Park, IL 60477-1615
Mailing address
314 Inverness TRL
McHenry, IL 60050-5905
Phone (815) 322-6104
Other providers in Tinley Park, IL
- Helping Hands LLC
- Hematogenix Laboratory Services, LLC
- Waikeen Henderson
- Courtney Henley
- Aileen Mary Henneberry
- Brandie Henry
- Herbert C Becker Jr. MD, SC
- Adriana Paola Hernandez Orantes
- Rachel Hernandez
- Blanca E Herrera
All providers in Tinley Park, IL · Physician Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.