1548426745 NPI number — DR. AHMED N HASSAN MD

Table of content: DR. AHMED N HASSAN MD (NPI 1548426745)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548426745 NPI number — DR. AHMED N HASSAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HASSAN
Provider First Name:
AHMED
Provider Middle Name:
N
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548426745
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 S. WASHINGTON ST
Provider Second Line Business Mailing Address:
6TH FLOOR CNICU
Provider Business Mailing Address City Name:
NAPERVILLE
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-527-7235
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 S. WASHINGTON ST
Provider Second Line Business Practice Location Address:
6TH FLOOR CNICU
Provider Business Practice Location Address City Name:
NAPERVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60540-6054
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-527-7235
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  2010030926 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0200X , with the licence number: 036121123 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P01308445 . This is a "MEDICARE RAILROAD (INDIVIDUAL)" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 206147 . This is a "MEDICARE PTAN (GROUP)" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 206147244 . This is a "MEDICARE PTAN (INDIVIDUAL)" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 010030926 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".
  • Identifier: CA4748 . This is a "MEDICARE RAILROAD (GROUP)" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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