Individual provider Active NPI

Dima R Hanna, M.D.

  • Family Medicine Physician
  • Morton Grove, IL
National Provider Identifier
1710041892
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
36060 Issued in AZ
Practice address
6605 Maple St
Morton Grove, IL 60053-1425
Phone
(623) 334-8670
Fax
(623) 334-8675
NPI assigned
Dec 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 36060 AZ Primary

Addresses

Primary practice location

6605 Maple St
Morton Grove, IL 60053-1425

Mailing address

17218 N 72ND Dr
100
Glendale, AZ 85308-8562
Phone (623) 334-8670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071015000212 IL Practitioner - Family Practice 1951497452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4726 W Oakton St
Skokie, IL 60076-3000
Phone (847) 674-0455

8301 Skokie Blvd
Skokie, IL 60077-2546
Phone (847) 674-0455

Hospital & facility affiliations

  • Americhoice Health Care, Inc Home health agency, Northbrook, IL, CCN 148214
  • Northshore University Healthsystem - Evanston Hospital Hospital, Evanston, IL, CCN 140010
  • Swedish Hospital Hospital, Chicago, IL, CCN 140114
  • Advocate Lutheran General Hospital Hospital, Park Ridge, IL, CCN 140223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Skokie Family Clinic P.C. CurrentSince Sep 1, 2009 Accepting new patients
Dima Hanna Past Accepting new patients

Locations

8301 Skokie Blvd
Skokie, IL 60077
Phone (847) 674-0455

4726 Oakton St
Skokie, IL 60076
Phone (847) 674-0455

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190073600000",
    "number": "1710041892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17218 N 72ND DR",
            "address_2": "100",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088562",
            "telephone_number": "623-334-8670",
            "fax_number": "623-334-8675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6605 MAPLE ST",
            "city": "MORTON GROVE",
            "state": "IL",
            "postal_code": "600531425",
            "telephone_number": "623-334-8670",
            "fax_number": "623-334-8675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "DIMA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-21",
        "last_updated": "2007-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "36060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton Grove, IL

Sources for this page

Verify at the official NPI Registry.