Basic Information
Provider Information
NPI: 1154542132
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAHS
FirstName: SETH
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1275 HAWTHORN RD
Address2:  
City: SALEM
State: IL
PostalCode: 628811028
CountryCode: US
TelephoneNumber: 6185484545
FaxNumber: 6185484577
Practice Location
Address1: 1275 HAWTHORN RD
Address2:  
City: SALEM
State: IL
PostalCode: 628811028
CountryCode: US
TelephoneNumber: 6185484545
FaxNumber: 6185484577
Other Information
ProviderEnumerationDate: 05/01/2007
LastUpdateDate: 05/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X125-051124ILN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000X036124033ILY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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