Organization
N HASAN MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIDAL HASAN MD (PRESIDENT)
(773) 978-4330
Entity
Organization
Contact information
Practice address
2315 E 93RD ST STE 339, CHICAGO, IL 60617-3916
(773) 978-4330
Mailing address
PO BOX 1200, ORLAND PARK, IL 60462-8200
(773) 978-4330
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036091656
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091656
—
IL
05
—
200241230A
—
IN
Enumeration date
08/30/2006
Last updated
07/11/2007
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