Individual
IMRAN HASSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 W CARPENTER ST, 2 ND FLOOR, SPRINGFIELD, IL 62702-4901
(217) 545-1025
(217) 545-0952
Mailing address
PO BOX 19638, SPRINGFIELD, IL 62794-9638
(217) 545-1025
(217) 545-0952
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
41912
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116661
—
IL
05
—
333677800
—
MN
Enumeration date
01/24/2006
Last updated
10/24/2012
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