Individual
HASAN FARID HASAN OTHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
15 FOUNDERS LN, JACKSONVILLE, IL 62650-3919
(217) 243-0300
(217) 245-6775
Mailing address
15 FOUNDERS LN, JACKSONVILLE, IL 62650-3919
(217) 243-0300
(217) 245-6775
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036160282
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036160282
IL MD LICENSE
IL
Enumeration date
06/13/2019
Last updated
03/28/2024
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