Provider Demographics
NPI:1528068699
Name:AFRAM, HANY M (MD)
Entity type:Individual
Prefix:
First Name:HANY
Middle Name:M
Last Name:AFRAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6785 WEAVER RD
Mailing Address - Street 2:STE D
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-8055
Mailing Address - Country:US
Mailing Address - Phone:920-451-8142
Mailing Address - Fax:920-451-8159
Practice Address - Street 1:6067 STRATHMOOR DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-6631
Practice Address - Country:US
Practice Address - Phone:920-451-8142
Practice Address - Fax:920-451-8159
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-070631207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C39669Medicare UPIN