Ellen M Hennecke, DO

NPI #1699751156 in Evergreen Park, Illinois

Provider Information

NPI Number: 1699751156
Entity Type: Individual
Name: Ellen M Hennecke, DO
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Family Medicine
Credential: DO
Enumeration Date: Dec 16, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 3927 W 95TH ST
City: Evergreen Park
State: Illinois
ZIP Code: 60805-1903
Phone: (708) 952-4566

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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Organizations

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